1962483149 NPI number — ROGELIO EDUARDO ROJAS MD

Table of content: ROGELIO EDUARDO ROJAS MD (NPI 1962483149)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962483149 NPI number — ROGELIO EDUARDO ROJAS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROJAS
Provider First Name:
ROGELIO
Provider Middle Name:
EDUARDO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962483149
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 720059
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78504-0059
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-992-0707
Provider Business Mailing Address Fax Number:
956-992-0707

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5111 S MCCOLL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDINBURG
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78539-8278
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-683-0404
Provider Business Practice Location Address Fax Number:
956-683-0450
Provider Enumeration Date:
11/07/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X , with the licence number:  L9876 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207P00000X , with the licence number: L9876 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)