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General NPI Number Information
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NPI Number | 1992906762
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Entity Type | Organization
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Legal Business Name | JOSE E IGOA MD PA
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 07/16/2009
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Provider Practice Location Address
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Address Line | 3600 N 23RD ST SUITE 103
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City | MCALLEN
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State | TX
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Zip | 78501-6144
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Country | US
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Telephone | 956-682-4401
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Fax | 956-664-9081
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Provider Business Mailing Address
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Address Line | PO BOX 1448
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City | MCALLEN
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State | TX
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Zip | 78505-1448
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Country | US
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Telephone | 956-682-4401
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Fax | 956-664-9081
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSE E. IGOA
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Credential | MD
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Telephone | 956-682-4401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA 05400
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA 05401
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G5833
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License Number State | TX
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