Healthcare Provider Details

I. General information

NPI: 1356502488
Provider Name (Legal Business Name): GENEVIEVE P. MEJIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GENEVIEVE A. PFLUGER MD

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 EAST HARRIS
SAN ANGELO TX
76903
US

IV. Provider business mailing address

PO BOX 22000
SAN ANGELO TX
76902-7200
US

V. Phone/Fax

Practice location:
  • Phone: 325-658-1511
  • Fax:
Mailing address:
  • Phone: 325-658-1511
  • Fax: 325-481-2166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberP4203
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: