Provider Demographics
NPI:1831154970
Name:PALLARES, VICTOR ALBERTO (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:ALBERTO
Last Name:PALLARES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 PEASE ST
Mailing Address - Street 2:STE 305
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8348
Mailing Address - Country:US
Mailing Address - Phone:956-440-7246
Mailing Address - Fax:956-440-9517
Practice Address - Street 1:2121 PEASE ST
Practice Address - Street 2:STE 305
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8348
Practice Address - Country:US
Practice Address - Phone:956-440-7246
Practice Address - Fax:956-440-9517
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3867207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129839100OtherINDIV. VALLEY HEALTH PLAN
TX050092208OtherINDIV. MEDICARE RR#
TX8H0760OtherINDIVIDUAL BCBS #
TXP00462542OtherMEDICARE RAILROAD-PA
TX118423604Medicaid
TX8BC500OtherBLUE CROSS BLUE SHIELD TEXAS
TXJ3867OtherLICENSE #
TX118423605Medicaid
TX8A1848Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE #
TX8F7090Medicare PIN
TX118423605Medicaid