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NPI Code Detail

MEDICARE: DR. JUAN HERRADA M.D.

MEDICARE: DR. JUAN HERRADA M.D.
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
1207RH0003XHematology & Oncology PhysicianJ2449TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215934674
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUAN HERRADA M.D.
Provider Business Mailing Address
First Line : PO BOX 911230
Second Line :
City : DALLAS
State : TX
Zip : 75391-1230
Country : US
Telephone Number : 972-997-8000
Fax Number : 972-437-9605
Provider Business Practice Location Address
First Line : 7848 GATEWAY BLVD E
Second Line :
City : EL PASO
State : TX
Zip : 79915-1815
Country : US
Telephone Number : 915-599-1313
Fax Number : 915-599-1635
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 02/28/2008

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Directions to “ DR. JUAN HERRADA M.D.” Practice Location

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