Healthcare Provider Details

I. General information

NPI: 1205831542
Provider Name (Legal Business Name): FREDRICKA M BORLAND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 02/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E SAVANNAH AVE BLDG A
MCALLEN TX
78503-1241
US

IV. Provider business mailing address

110 E SAVANNAH AVE BLDG A
MCALLEN TX
78503-1241
US

V. Phone/Fax

Practice location:
  • Phone: 956-631-8155
  • Fax: 956-631-8187
Mailing address:
  • Phone: 956-631-8155
  • Fax: 956-631-8187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberE6244
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: