Provider Demographics
NPI:1518084706
Name:VICTOR A. PALLARES, MDPA
Entity Type:Organization
Organization Name:VICTOR A. PALLARES, MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:PALLARES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-350-0900
Mailing Address - Street 1:5700 N EXPRESSWAY # 7783
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-4353
Mailing Address - Country:US
Mailing Address - Phone:956-350-0900
Mailing Address - Fax:956-350-0906
Practice Address - Street 1:5700 N EXPRESSWAY # 7783
Practice Address - Street 2:SUITE 101
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-4353
Practice Address - Country:US
Practice Address - Phone:956-350-0900
Practice Address - Fax:956-350-0906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3867207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDG9195OtherMEDICARE RAILROAD
TX0037RDOtherBLUE CROSS BLUE SHIELD TEXAS
TX191674401Medicaid
TX118423605Medicaid
TX00Y588Medicare PIN
TXDG9195OtherMEDICARE RAILROAD