Individual
MARCELA JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2801 FRANCISCAN DR., ST.JOSEPH REGIONAL MEDICAL CENTER, BRYAN, TX 77802
(512) 814-0298
(512) 597-2713
Mailing address
PO BOX 2386, BRAZOS VALLEY PATHOLOGY, ROUND ROCK, TX 78664
(903) 312-0870
(512) 597-2713
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MT182217
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
N3762
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2141889
—
TX
01
—
TXB104859
MEDICARE
TX
Enumeration date
04/19/2007
Last updated
10/30/2014
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