Individual
DAIVYD ALEXANDER PALENCIA PACHECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
56 FRANKLIN ST STE 1, WATERBURY, CT 06706-1281
(203) 709-6479
Mailing address
7703 FLOYD CURL DR # 7742, SAN ANTONIO, TX 78229-3900
(210) 567-5711
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
BP10065359
CT
390200000X
Student in an Organized Health Care Education/Training Program
BP10065359
TX
Other
Enumeration date
06/26/2018
Last updated
06/24/2019
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