Provider Demographics
NPI:1336131325
Name:PAZMINO, PATRICIO AUGUSTO (PHD, MD)
Entity Type:Individual
Prefix:
First Name:PATRICIO
Middle Name:AUGUSTO
Last Name:PAZMINO
Suffix:
Gender:M
Credentials:PHD, MD
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Other - First Name:
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Mailing Address - Street 1:1701 N MESA ST
Mailing Address - Street 2:STE 101
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3503
Mailing Address - Country:US
Mailing Address - Phone:915-534-7755
Mailing Address - Fax:915-534-7788
Practice Address - Street 1:1701 N MESA ST
Practice Address - Street 2:STE 101
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3503
Practice Address - Country:US
Practice Address - Phone:915-534-7755
Practice Address - Fax:915-534-7788
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2016-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG6589207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0984197-01Medicaid
B25409Medicare UPIN
TX0984197-01Medicaid