Provider Demographics
NPI:1396894077
Name:PASKO, CAROL LINDA (MD, MSCI)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:LINDA
Last Name:PASKO
Suffix:
Gender:F
Credentials:MD, MSCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7930 ROANOKE RUN
Mailing Address - Street 2:UNIT 1101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-5204
Mailing Address - Country:US
Mailing Address - Phone:210-614-4053
Mailing Address - Fax:
Practice Address - Street 1:7930 ROANOKE RUN
Practice Address - Street 2:UNIT 1101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-5204
Practice Address - Country:US
Practice Address - Phone:210-614-4053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA82199207Q00000X
WI35910-020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine