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General NPI Number Information
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NPI Number | 1679630933
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Entity Type | Individual
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Provider Name | JOHN RODRIGUEZ PACHECO L.P.C.
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Gender | Male
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1319 CORPUS CHRISTI ST
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City | LAREDO
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State | TX
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Zip | 78040-5356
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Country | US
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Telephone | 956-236-1405
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Fax | 956-723-4770
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Provider Business Mailing Address
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Address Line | 1706 LOWRY RD
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City | LAREDO
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State | TX
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Zip | 78045-7051
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Country | US
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Telephone | 956-236-1405
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Fax | 956-723-4770
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 14888
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License Number State | TX
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