diff --git a/enfermero_portal.php b/enfermero_portal.php
index a2632b2..54b39a2 100644
--- a/enfermero_portal.php
+++ b/enfermero_portal.php
@@ -1238,8 +1238,8 @@ const formVer = {
                 <label class="form-label small mb-1">Teléfono</label>
                 <div class="input-group input-group-sm">
                   <select id="na-np-prefijo" class="form-select form-select-sm" style="max-width:72px">
-                    <option value="57" selected>+57</option>
-                    <option value="58">+58</option>
+                    <option value="57" selected>57</option>
+                    <option value="58">58</option>
                   </select>
                   <input type="tel" id="na-np-telefono" class="form-control form-control-sm"
                          placeholder="3001234567">
diff --git a/lab_pacientes.php b/lab_pacientes.php
index a329ae7..3b4919c 100644
--- a/lab_pacientes.php
+++ b/lab_pacientes.php
@@ -129,7 +129,13 @@ require_once __DIR__ . '/shared/components/sidebar.php';
                         </div>
                         <div class="col-md-4">
                             <label class="form-label">Teléfono</label>
-                            <input type="tel" class="form-control" name="telefono" id="pac-tel">
+                            <div class="input-group">
+                              <select id="pac-tel-prefijo" class="form-select" style="max-width:80px">
+                                <option value="57" selected>57</option>
+                                <option value="58">58</option>
+                              </select>
+                              <input type="tel" class="form-control" name="telefono" id="pac-tel" placeholder="3001234567">
+                            </div>
                         </div>
                         <div class="col-md-4">
                             <label class="form-label">Email</label>
@@ -299,7 +305,13 @@ function abrirFormulario(p = null) {
         document.getElementById('pac-nombre').value  = p.nombre_completo || '';
         document.getElementById('pac-doc').value     = p.numero_documento || '';
         document.getElementById('pac-tipo-doc').value= p.tipo_documento || 'CC';
-        document.getElementById('pac-tel').value     = p.telefono || '';
+        document.getElementById('pac-tel-prefijo').value = '57';
+        let telRaw = p.telefono || '';
+        if (/^(57|58)\d{10}$/.test(telRaw)) {
+            document.getElementById('pac-tel-prefijo').value = telRaw.slice(0, 2);
+            telRaw = telRaw.slice(2);
+        }
+        document.getElementById('pac-tel').value     = telRaw;
         document.getElementById('pac-email').value   = p.email || '';
         document.getElementById('pac-fnac').value    = p.fecha_nacimiento || '';
         document.getElementById('pac-genero').value  = p.genero || '';
@@ -325,6 +337,13 @@ async function guardarPaciente() {
     const datos = Object.fromEntries(new FormData(form).entries());
     if (!datos.id) delete datos.id;
 
+    // Normalizar teléfono: anteponer prefijo seleccionado
+    const prefijo = document.getElementById('pac-tel-prefijo').value || '57';
+    let tel = (datos.telefono || '').replace(/[^0-9+]/g, '');
+    if (tel.startsWith('+')) tel = tel.slice(1);
+    if (tel.length === 10) tel = prefijo + tel;
+    datos.telefono = tel || null;
+
     const r = await fetch('api/lab/save_paciente.php', {
         method: 'POST',
         headers: {'Content-Type':'application/json'},