Provider Demographics
NPI:1861213688
Name:PAEZ, KARINA TERESA
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:TERESA
Last Name:PAEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 WINGATE CT
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-8142
Mailing Address - Country:US
Mailing Address - Phone:956-326-5296
Mailing Address - Fax:
Practice Address - Street 1:121 CALLE DEL NORTE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-9133
Practice Address - Country:US
Practice Address - Phone:956-726-1646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant