Provider Demographics
NPI:1407881634
Name:PACHECO, HECTOR RAFAEL (RPH)
Entity type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:RAFAEL
Last Name:PACHECO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 CANTERBURY NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-6436
Mailing Address - Country:US
Mailing Address - Phone:505-332-6687
Mailing Address - Fax:505-332-6687
Practice Address - Street 1:4500 ALEXANDER BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-6805
Practice Address - Country:US
Practice Address - Phone:505-345-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22618183500000X
NMRP00006623183500000X
AZ14479183500000X
PARP439786183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist