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General NPI Number Information
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NPI Number | 1235750092
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Entity Type | Individual
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Provider Name | JUAN PABLO TREJO PACHECO TORRES MD
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Gender | Male
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Dates
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Enumeration Date | 05/04/2020
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 111 HIGHWAY 70E
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City | DICKSON
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State | TN
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Zip | 37055-2080
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Country | US
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Telephone | 615-446-0446
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Fax |
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Provider Business Mailing Address
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Address Line | 7113 CHARLOTTE PIKE APT 662
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City | NASHVILLE
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State | TN
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Zip | 37209
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Country | US
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Telephone | 214-712-2439
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Fax |
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 67447
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 67447
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License Number State | TN
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