Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | K3373 | TX |
N | 2080P0214X | Pediatric Pulmonologist | K3373 | TX |
NPI | 1982896304 |
---|---|
Provider Name | Susan E. Pacheco |
First Address | Houston, TX 77216-1088 |
Second Address | Houston, TX 77030-3000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2007 |
Last Update Date | 12/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
126603306 | (05) | TX |
126603307 | CSHCN (01) | TX |
8AL071 | BCBS (01) | TX |
G56536 | (02) |