Provider Demographics
NPI:1124147145
Name:PALACIOS, MARIA ESPERANZA (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ESPERANZA
Last Name:PALACIOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:MOKADDEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7151 CASCADE VALLEY CT
Mailing Address - Street 2:# 105
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128
Mailing Address - Country:US
Mailing Address - Phone:702-565-4917
Mailing Address - Fax:702-562-8680
Practice Address - Street 1:7151 CASCADE VALLEY CT
Practice Address - Street 2:# 105
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128
Practice Address - Country:US
Practice Address - Phone:702-565-4917
Practice Address - Fax:702-562-8680
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV117852083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine