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General NPI Number Information
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NPI Number | 1639764186
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Entity Type | Individual
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Provider Name | CURTIS SAMUEL PACHECO MD
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Gender | Male
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Dates
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Enumeration Date | 03/06/2021
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | WILFORD HALL AMBULATORY SURGICAL CENTER 1100 WILFORD HALL LOOP, BLDG. 4554, 59 MDW/GME
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City | JBSA LACKLAND
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State | TX
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Zip | 78236-9908
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Country | US
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Telephone | 219-292-4277
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 WILFORD HALL LOOP BLDG 4554
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City | LACKLAND AFB
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State | TX
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Zip | 78236-5638
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Country | US
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Telephone | 210-292-5042
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Fax | 210-292-7033
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | DR.0069602
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License Number State | CO
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