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General NPI Number Information
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NPI Number | 1215970116
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Entity Type | Individual
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Provider Name | PEDRO LUIS VASQUEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1040 W JEFFERSON ST
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City | BROWNSVILLE
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State | TX
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Zip | 78520-6338
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Country | US
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Telephone | 956-698-5493
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Fax | 956-698-4423
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Provider Business Mailing Address
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Address Line | 1040 W JEFFERSON ST
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City | BROWNSVILLE
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State | TX
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Zip | 78520-6338
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Country | US
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Telephone | 956-698-5493
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Fax | 956-698-4423
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | L7235
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License Number State | TX
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