Basic Information
| Provider Information | |||||||||
| NPI: | 1972582310 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOUJAN | ||||||||
| FirstName: | PABLO | ||||||||
| MiddleName: | MIGUEL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 440 RAYNOLDS ST # 51015 | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799051613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152155666 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2000 A TRANSMOUNTAIN RD. | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152155666 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2006 | ||||||||
| LastUpdateDate: | 11/20/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | ME 93920 | FL | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | M3331 | TX | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.