Individual
DR. ROBERTO EDUARDO MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
309 JACKSON ST, MONROE, LA 71201-7407
(806) 831-8734
(940) 205-5028
Mailing address
309 JACKSON ST, MONROE, LA 71201-7407
(806) 831-8734
(402) 055-0289
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
29919
OK
207P00000X
Emergency Medicine Physician
311630
LA
207Q00000X
Family Medicine Physician
BP10045433
TX
207QG0300X
Geriatric Medicine (Family Medicine) Physician
29919
OK
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
BP10045433
TX
Other
Enumeration date
06/11/2013
Last updated
04/20/2021
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