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NPI Code Detail

MEDICARE: MR. LUIS HUMBERTO TAMEZ PHYSISIAN ASSISTANT

MEDICARE:  MR. LUIS HUMBERTO TAMEZ  PHYSISIAN ASSISTANT
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
1363AM0700XMedical Physician AssistantPA04091TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1L0143546OTHERTXDPS REGISTRATION NUMBER
2PA04091OTHERTXPHYSICIAN ASSISTANT PERMI

General Provider Information

NPI Number : 1942362397
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LUIS HUMBERTO TAMEZ PHYSISIAN ASSISTANT
Provider Business Mailing Address
First Line : 2408 TREASURE HILLS CT
Second Line :
City : HARLINGEN
State : TX
Zip : 78550-8646
Country : US
Telephone Number : 956-982-1001
Fax Number : 956-982-1938
Provider Business Practice Location Address
First Line : 3302 BOCA CHICA BLVD STE 109
Second Line :
City : BROWNSVILLE
State : TX
Zip : 78521-4271
Country : US
Telephone Number : 956-982-1001
Fax Number : 956-982-1938
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2006
Last Update Date : 07/08/2007

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Directions to “ MR. LUIS HUMBERTO TAMEZ PHYSISIAN ASSISTANT” Practice Location

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