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General NPI Number Information
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NPI Number | 1740301985
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Entity Type | Organization
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Legal Business Name | LA JOYA'S NEIGHBORHOOD DOCTOR, P.A.
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 05/26/2009
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Provider Practice Location Address
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Address Line | 2121 E GRIFFIN PKWY STE 6
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City | MISSION
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State | TX
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Zip | 78572-3072
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Country | US
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Telephone | 956-583-2300
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Fax | 956-583-2295
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Provider Business Mailing Address
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Address Line | 2121 E GRIFFIN PKWY STE 6
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City | MISSION
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State | TX
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Zip | 78572-3241
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Country | US
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Telephone | 956-583-2300
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Fax | 956-583-2295
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. HECTOR M SALAS
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Credential | B.S.
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Telephone | 956-583-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | J8951
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License Number State | TX
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