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General NPI Number Information
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NPI Number | 1518441567
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Entity Type | Organization
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Legal Business Name | AMPUTATION PREVENTION CENTER OF MISSION PA
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Dates
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Enumeration Date | 09/16/2018
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Last Update Date | 12/03/2019
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Provider Practice Location Address
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Address Line | 1317 ST CLAIRE BLVD STE A5
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City | MISSION
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State | TX
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Zip | 78572-6636
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Country | US
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Telephone | 956-212-3853
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Fax |
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Provider Business Mailing Address
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Address Line | 5601 N 5TH ST
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City | MCALLEN
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State | TX
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Zip | 78504-2732
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Country | US
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Telephone | 956-878-9610
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/AUTHORIZED OFFICAL
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Name | DR. PEDRO ANTONIO MEGO
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Credential | MD
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Telephone | 956-878-9610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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