MEDICARE: MS. CHRISTINE M PACHECO CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	APN.0003498-CRNA	CO
2	367500000X	Certified Registered Nurse Anesthetist	90919	CO
3	367500000X	Certified Registered Nurse Anesthetist	CRNA1528	AZ
4	367500000X	Certified Registered Nurse Anesthetist	1058872	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578568143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINE M PACHECO CRNA

Provider Business Mailing Address
First Line	:	PO BOX 844658
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-4658
Country	:	US
Telephone Number	:	800-994-0371
Fax Number	:	254-215-9722

Provider Business Practice Location Address
First Line	:	810 W HIGHWAY 71
Second Line	:
City	:	MARBLE FALLS
State	:	TX
Zip	:	78654-8602
Country	:	US
Telephone Number	:	830-201-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	03/17/2025

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