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General NPI Number Information
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NPI Number | 1720101454
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Entity Type | Organization
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Legal Business Name | HAYDEE TE NIEVERA, M.D., PA
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 1201 CALLE MILAGROS STE A
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City | BROWNSVILLE
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State | TX
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Zip | 78526-1361
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Country | US
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Telephone | 956-544-4700
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Fax | 945-544-4774
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Provider Business Mailing Address
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Address Line | 1201 CALLE MILAGROS STE A
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City | BROWNSVILLE
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State | TX
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Zip | 78526-1361
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Country | US
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Telephone | 956-544-4700
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Fax | 945-544-4774
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HAYDEE TE NIEVERA
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Credential | MD
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Telephone | 956-544-4700
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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 | L0881
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License Number State | TX
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