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General NPI Number Information
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NPI Number | 1851411052
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Entity Type | Organization
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Legal Business Name | INEMESIT EPHRAM UDOR MD. P.A.
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 11/24/2008
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Provider Practice Location Address
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Address Line | 2517 W. TRENTON RD. BLDG A STE 4
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City | EDINBURG
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State | TX
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Zip | 78539-5070
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Country | US
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Telephone | 956-631-7312
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Fax | 956-631-7307
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Provider Business Mailing Address
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Address Line | 2517 W TRENTON RD. BIDG A STE 4
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City | EDINBURG
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State | TX
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Zip | 78539-5070
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Country | US
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Telephone | 956-631-7312
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Fax | 956-631-7307
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Authorized Official
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Title or Position | OWNER
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Name | INEMESIT E UDOR
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Credential | MD. P.A.
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Telephone | 956-631-7312
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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 | K6377
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License Number State | TX
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