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General NPI Number Information
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NPI Number | 1992526578
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Entity Type | Individual
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Provider Name | CECILIE PACHECO
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Gender | Female
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 855 ROLLINGBROOK DR
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City | BAYTOWN
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State | TX
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Zip | 77521-4073
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Country | US
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Telephone | 281-839-2789
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Fax |
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Provider Business Mailing Address
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Address Line | 5326 RIO DR
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City | BAYTOWN
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State | TX
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Zip | 77521-2661
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Country | US
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Telephone | 815-501-5548
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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 | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | BACB1157063
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License Number State | TX
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