Provider Demographics
NPI:1689841876
Name:MEDINA, PABLO OSCAR JR (MD)
Entity Type:Individual
Prefix:DR
First Name:PABLO
Middle Name:OSCAR
Last Name:MEDINA
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:DIVISION OF UNDERSEA AND HYPERBARIC MEDICINE
Mailing Address - Street 2:3551 ROGER BROOKE DR
Mailing Address - City:JBSA FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234
Mailing Address - Country:US
Mailing Address - Phone:210-539-8000
Mailing Address - Fax:
Practice Address - Street 1:DIVISION OF UNDERSEA AND HYPERBARIC MEDICINE
Practice Address - Street 2:3551 ROGER BROOKE DR
Practice Address - City:JBSA FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234
Practice Address - Country:US
Practice Address - Phone:210-539-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2021-09-27
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Provider Licenses
StateLicense IDTaxonomies
VA0101247764207PE0005X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services