MEDICARE: PABLO MIGUEL MOUJAN M.D.

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	207L00000X	Anesthesiology Physician	ME 93920	FL
2	207L00000X	Anesthesiology Physician	M3331	TX

General Provider Information

NPI Number	:	1972582310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PABLO MIGUEL MOUJAN M.D.

Provider Business Mailing Address
First Line	:	440 RAYNOLDS ST # 51015
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79905-1613
Country	:	US
Telephone Number	:	915-215-5666
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 A TRANSMOUNTAIN RD.
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79911
Country	:	US
Telephone Number	:	915-215-5666
Fax Number	:

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

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	11/20/2019

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