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Organization
MEDICAL SPECIALIST GROUP PA
Active
Organization
MEDICAL SPECIALIST GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAIRO ANTONIO PUENTES MD (PRESIDENT & CEO)
(361) 852-0852
Entity
Organization
Contact information
Practice address
3434 SARATOGA BOULEVARD, CORPUS CHRISTI, TX 78415
(361) 852-0852
(361) 852-0256
Mailing address
3434 SARATOGA BLVD, CORPUS CHRISTI, TX 78415-5805
(361) 852-0852
(361) 852-0256
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MDE2071
TX
Other
Enumeration date
06/13/2007
Last updated
02/19/2008
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