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NPI Code Detail

MEDICARE: ENA VANESA PACHECO

MEDICARE: ENA VANESA PACHECO
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1740975036
Entity Type Code : Individual
Provider Name (Legal Business Name) : ENA VANESA PACHECO
Provider Business Mailing Address
First Line : 1930 HERITAGE PARK DR APT 126
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73120-7567
Country : US
Telephone Number : 479-629-1774
Fax Number :
Provider Business Practice Location Address
First Line : 2250 N AIRPORT RD
Second Line :
City : WEATHERFORD
State : OK
Zip : 73096-3351
Country : US
Telephone Number : 405-424-7711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2023
Last Update Date : 02/18/2026

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Directions to “ ENA VANESA PACHECO ” Practice Location

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