Organization
ENRIQUE PASTRANA, M.D., P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ENRIQUE PASTRANA M.D. (PRESIDENT , OWNER)
(636) 496-5030
Entity
Organization
Contact information
Practice address
1011 BOWLES AVE., SUITE 300, FENTON, MO 63026-2387
(636) 496-5030
(636) 496-5035
Mailing address
1011 BOWLES AVE., SUITE 300, FENTON, MO 63026-2387
(636) 496-5030
(636) 496-5035
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208176503
—
MO
Enumeration date
04/25/2007
Last updated
05/01/2009
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