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General NPI Number Information
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NPI Number | 1497100143
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Entity Type | Individual
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Provider Name | JUAN JOSE PALACIOS M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 6431 FANNIN ST STE MSB 3228
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City | HOUSTON
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State | TX
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Zip | 77030-1501
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Country | US
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Telephone | 713-500-5650
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Fax | 713-500-0588
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Provider Business Mailing Address
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Address Line | 1611 NW 12 AVENUE
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City | MIAMI
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State | FL
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Zip | 33136
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Country | US
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Telephone | 305-585-5437
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | FL
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