Provider Demographics
NPI:1902892417
Name:PASCUAL, ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:PASCUAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:S
Other - Last Name:PASCUAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1701 N GREENVILLE AVE STE 801
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-1853
Mailing Address - Country:US
Mailing Address - Phone:844-233-1967
Mailing Address - Fax:972-373-4062
Practice Address - Street 1:1701 N GREENVILLE AVE STE 801
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-1853
Practice Address - Country:US
Practice Address - Phone:844-233-1967
Practice Address - Fax:972-373-4062
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0869207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092663603Medicaid
TXC20247Medicare UPIN
TX323681YM2MMedicare PIN
TX092663601Medicaid