Provider Demographics
NPI:1952301137
Name:PALAFOX, MANUEL J (DO)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:J
Last Name:PALAFOX
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1387 GEORGE DIETER DR BLDG B
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-7410
Mailing Address - Country:US
Mailing Address - Phone:915-275-0224
Mailing Address - Fax:915-275-0225
Practice Address - Street 1:1387 GEORGE DIETER DR BLDG B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7410
Practice Address - Country:US
Practice Address - Phone:915-275-0224
Practice Address - Fax:915-275-0225
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL6136207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167570402OtherTHSTEPS-MEDICAID
TX167570401Medicaid
TX8AW501OtherBLUE CROSS AND BLUE SHIELD OF TEXAS
TX8C0224Medicare PIN
TX167570401Medicaid