Provider Demographics
NPI:1184625618
Name:OPTOMETRAS PACHECO PSC
Entity type:Organization
Organization Name:OPTOMETRAS PACHECO PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:PACHECO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-749-0909
Mailing Address - Street 1:11 CALLE PRINCIPAL
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2028
Mailing Address - Country:US
Mailing Address - Phone:787-783-8994
Mailing Address - Fax:787-783-8994
Practice Address - Street 1:SAN PATRICIO APTS
Practice Address - Street 2:AL LADO DE BED, BATH AND BEYOND
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-3200
Practice Address - Country:US
Practice Address - Phone:787-749-0909
Practice Address - Fax:787-749-1213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR89152W00000X
PR103152W00000X
PR518152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty