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General NPI Number Information
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NPI Number | 1629072285
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Entity Type | Individual
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Provider Name | LORENZO R PELLY M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 09/16/2015
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Provider Practice Location Address
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Address Line | 2300 CENTRAL BLVD
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City | BROWNSVILLE
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State | TX
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Zip | 78520-8714
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Country | US
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Telephone | 956-546-5194
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Fax | 956-544-6657
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Provider Business Mailing Address
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Address Line | PO BOX 3190
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City | BROWNSVILLE
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State | TX
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Zip | 78523-3190
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Country | US
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Telephone | 956-544-0755
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Fax | 956-544-6657
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | G2453
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G2453
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License Number State | TX
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