MEDICARE: PROMED PREFERRED TX 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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1356164842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROMED PREFERRED TX PLLC

Provider Business Mailing Address
First Line	:	329 S OYSTER BAY RD # 2059
Second Line	:
City	:	PLAINVIEW
State	:	NY
Zip	:	11803-3301
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	324 W NOLANA AVE
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-2528
Country	:	US
Telephone Number	:	956-679-3112
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	LEV GRINMAN
Credential	:	MD
Telephone Number	:	646-673-1660

Provider Enumeration Date	:	11/04/2024
Last Update Date	:	01/19/2026

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