Provider Demographics
NPI:1023000379
Name:TORRES, PEDRO P (MD)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:P
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 271208
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78427-1208
Mailing Address - Country:US
Mailing Address - Phone:361-888-8401
Mailing Address - Fax:361-887-7472
Practice Address - Street 1:3301 S ALAMEDA ST
Practice Address - Street 2:STE.305
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1882
Practice Address - Country:US
Practice Address - Phone:361-888-8401
Practice Address - Fax:361-887-7472
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4732208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098464302Medicaid
C22727Medicare UPIN
TX00GQ17Medicare PIN