Provider Demographics
NPI:1710388954
Name:PLEITEZ TECUN, CLAUDIA PATRICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:PATRICIA
Last Name:PLEITEZ TECUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 F AVE
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:AZ
Mailing Address - Zip Code:85607-1920
Mailing Address - Country:US
Mailing Address - Phone:520-364-6852
Mailing Address - Fax:520-364-4261
Practice Address - Street 1:815 E 15TH ST
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:AZ
Practice Address - Zip Code:85607-1631
Practice Address - Country:US
Practice Address - Phone:520-364-5437
Practice Address - Fax:520-364-4261
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY276798-1208000000X
AZ53134208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ190084Medicaid
NY03942981Medicaid