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Individual

MARELYN MEDINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
412 E DOVE AVE, MCALLEN, TX 78504-2240
(956) 686-7243
(956) 668-7123
Mailing address
412 E DOVE AVE, MCALLEN, TX 78504-2240
(956) 686-7243
(956) 668-7123

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
J9759
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036004201
TX
01
1258210001
PALMETTO DME
05
16886101
TX
01
3196639
BCBS BLUE LINK
01
340017711
RAILROAD MEDICARE
01
82010Y
BCBS
Enumeration date
08/24/2005
Last updated
10/25/2017
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