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General NPI Number Information
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NPI Number | 1457656647
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Entity Type | Organization
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Legal Business Name | JIMENEZ PEDIATRICS
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Dates
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Enumeration Date | 01/19/2011
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Last Update Date | 03/05/2012
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Provider Practice Location Address
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Address Line | 4634 S CLOSNER BLVD
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City | EDINBURG
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State | TX
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Zip | 78539-7279
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Country | US
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Telephone | 361-688-5594
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Fax | 956-702-2455
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Provider Business Mailing Address
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Address Line | 4634 S CLOSNER BLVD
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City | EDINBURG
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State | TX
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Zip | 78539-7279
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Country | US
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Telephone | 361-688-5594
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Fax | 956-702-2455
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID LEE JIMENEZ
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Credential | M.D.
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Telephone | 361-688-5594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | M8739
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License Number State | TX
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