Healthcare Provider Details

I. General information

NPI: 1790057107
Provider Name (Legal Business Name): GIOK TWAN TJOA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2012
Last Update Date: 01/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E DUKE AVE
MCALLEN TX
78504-5663
US

IV. Provider business mailing address

201 E DUKE AVE
MCALLEN TX
78504-5663
US

V. Phone/Fax

Practice location:
  • Phone: 956-618-0039
  • Fax:
Mailing address:
  • Phone: 956-618-0039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD 8464
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: