Provider Demographics
NPI:1962017996
Name:PACHECO, JANET (LMT)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:PACHECO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 SAN ANTONIO DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-4233
Mailing Address - Country:US
Mailing Address - Phone:214-418-0924
Mailing Address - Fax:
Practice Address - Street 1:3700 W 15TH ST BLDG B
Practice Address - Street 2:STE. 107B
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-4736
Practice Address - Country:US
Practice Address - Phone:214-418-0924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT129168225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist