Healthcare Provider Details

I. General information

NPI: 1588646145
Provider Name (Legal Business Name): OSCAR TIJERINA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S BRYAN RD
MISSION TX
78572-6613
US

IV. Provider business mailing address

2001 BRAZOS CT
MISSION TX
78572-7407
US

V. Phone/Fax

Practice location:
  • Phone: 956-580-9000
  • Fax:
Mailing address:
  • Phone: 956-581-2364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberJ1798
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: