Provider Demographics
NPI:1972560019
Name:PEPITO, DANTE M (MD)
Entity Type:Individual
Prefix:DR
First Name:DANTE
Middle Name:M
Last Name:PEPITO
Suffix:
Gender:M
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:PO BOX 61160
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-1160
Mailing Address - Country:US
Mailing Address - Phone:361-826-0650
Mailing Address - Fax:361-371-8376
Practice Address - Street 1:1290 FM 43 STE J
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78415-9773
Practice Address - Country:US
Practice Address - Phone:361-826-0650
Practice Address - Fax:361-826-0651
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1348208D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2I1388OtherMEDICARE
TX97071705Medicaid
TX8C6761Medicare ID - Type Unspecified