Provider Demographics
NPI:1235750092
Name:TREJO PACHECO TORRES, JUAN PABLO (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:PABLO
Last Name:TREJO PACHECO TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7113 CHARLOTTE PIKE
Mailing Address - Street 2:APT 662
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209
Mailing Address - Country:US
Mailing Address - Phone:214-712-2439
Mailing Address - Fax:
Practice Address - Street 1:111 HIGHWAY 70E
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2080
Practice Address - Country:US
Practice Address - Phone:615-446-0446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-04
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN67447208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist