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General NPI Number Information
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NPI Number | 1992297816
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Entity Type | Organization
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Legal Business Name | PAK MEDICAL GROUP, PLLC
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Dates
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Enumeration Date | 06/06/2018
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 1762 E COMMON ST
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-6059
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Country | US
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Telephone | 830-730-8580
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Fax | 830-327-1021
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Provider Business Mailing Address
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Address Line | 425 W COLONIAL DR STE 303
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City | ORLANDO
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State | FL
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Zip | 32804-6863
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Country | US
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Telephone | 321-343-6833
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Fax | 407-286-4515
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | VERONICA JEAN HARLAN
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Credential |
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Telephone | 106-302-2072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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