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General NPI Number Information
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NPI Number | 1386293025
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Entity Type | Individual
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Provider Name | MARIDYAXIS PACHECO
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Gender | Female
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 9720 JONES RD STE 130
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City | HOUSTON
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State | TX
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Zip | 77065-4776
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Country | US
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Telephone | 832-938-7325
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Fax | 832-412-4987
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Provider Business Mailing Address
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Address Line | 9720 JONES RD STE 130
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City | HOUSTON
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State | TX
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Zip | 77065-4776
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Country | US
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Telephone | 832-938-7325
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Fax | 832-412-4987
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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 | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | 148662
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number | 148662
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License Number State |
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