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General NPI Number Information
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NPI Number | 1740308378
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Entity Type | Individual
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Provider Name | TRUDI DIANE PACHECO LOT
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 04/12/2017
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Provider Practice Location Address
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Address Line | 7007 N 10TH ST
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City | MCALLEN
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State | TX
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Zip | 78504-3104
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Country | US
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Telephone | 956-661-0475
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Fax |
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Provider Business Mailing Address
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Address Line | 317 LARK AVE
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City | MCALLEN
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State | TX
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Zip | 78504-2017
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Country | US
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Telephone | 956-687-4822
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 104062
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License Number State | TX
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