MEDICARE: DR. JOSE FEDERICO VALLEJO-MANZUR 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
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	N2328	TX
2	207RP1001X	Pulmonary Disease Physician	N2328	TX

General Provider Information

NPI Number	:	1447396015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE FEDERICO VALLEJO-MANZUR M.D.

Provider Business Mailing Address
First Line	:	PO BOX 6148
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78502-6148
Country	:	US
Telephone Number	:	956-362-8677
Fax Number	:	956-362-7253

Provider Business Practice Location Address
First Line	:	5300 N G ST STE 110
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-6550
Country	:	US
Telephone Number	:	956-540-9766
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	11/13/2023

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