Healthcare Provider Details

I. General information

NPI: 1154855815
Provider Name (Legal Business Name): ANDRES ESTEBAN ARBOLEDA MOREJON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 08/28/2020
Certification Date: 08/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 E 6TH ST STE 105
WESLACO TX
78596-6608
US

IV. Provider business mailing address

1330 E 6TH ST STE 105
WESLACO TX
78596-6608
US

V. Phone/Fax

Practice location:
  • Phone: 956-296-7710
  • Fax: 956-296-7705
Mailing address:
  • Phone: 956-296-7710
  • Fax: 956-296-7705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberS4912
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: