Healthcare Provider Details

I. General information

NPI: 1124203179
Provider Name (Legal Business Name): ANA MARIA PAEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 12/04/2020
Certification Date: 12/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3533 S ALAMEDA ST
CORPUS CHRISTI TX
78411-1721
US

IV. Provider business mailing address

3533 S ALAMEDA ST
CORPUS CHRISTI TX
78411-1721
US

V. Phone/Fax

Practice location:
  • Phone: 361-694-4986
  • Fax:
Mailing address:
  • Phone: 210-627-0044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberN6554
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: