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NPI Code Detail

MEDICARE: PRONTOMED CLINIC, PLLC

MEDICARE: PRONTOMED CLINIC, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/CenterMDE2071TX
2208100000XPhysical Medicine & Rehabilitation PhysicianE2071TX

General Provider Information

NPI Number : 1104128990
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRONTOMED CLINIC, PLLC
Provider Business Mailing Address
First Line : 3434 SARATOGA BLVD
Second Line : STE 103
City : CORPUS CHRISTI
State : TX
Zip : 78415-5822
Country : US
Telephone Number : 361-852-0852
Fax Number : 361-852-2280
Provider Business Practice Location Address
First Line : 3434 SARATOGA BLVD
Second Line : STE 103
City : CORPUS CHRISTI
State : TX
Zip : 78415-5822
Country : US
Telephone Number : 361-852-0852
Fax Number : 361-852-2280
Authorized Official
Title or Position : OWNER
Name : DR. JAIRO ANTONIO PUENTES
Credential : MD
Telephone Number : 361-852-0852
Provider Enumeration Date : 11/30/2010
Last Update Date : 04/01/2011

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Directions to “PRONTOMED CLINIC, PLLC ” Practice Location

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