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NPI Code Detail

MEDICARE: LAURA PACEK P.A.

MEDICARE: LAURA PACEK P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA01213TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3346885YK7YOTHERTXMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA01213OTHERTXPA LIC
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437193943
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA PACEK P.A.
Provider Business Mailing Address
First Line : 508 N RIEDEL ST
Second Line :
City : YORKTOWN
State : TX
Zip : 78164-1810
Country : US
Telephone Number : 361-564-9230
Fax Number :
Provider Business Practice Location Address
First Line : 508 N RIEDEL ST
Second Line :
City : YORKTOWN
State : TX
Zip : 78164-1810
Country : US
Telephone Number : 361-564-9230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 09/29/2021

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Directions to “ LAURA PACEK P.A.” Practice Location

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