MEDICARE: MICHAEL T. JELINEK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	H7167	TX
2	207RI0200X	Infectious Disease Physician	4301046479	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	81272N	OTHER	TX	BC/BS TX

General Provider Information

NPI Number	:	1144337627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL T. JELINEK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 3344
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78502-3344
Country	:	US
Telephone Number	:	956-631-5200
Fax Number	:	956-631-2812

Provider Business Practice Location Address
First Line	:	3108 CENTER POINT DR
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-4804
Country	:	US
Telephone Number	:	956-631-5200
Fax Number	:	956-631-2812

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	11/27/2007

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