Organization
MICHAEL DECANDIA M.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DECANDIA M.D. (OWNER)
(956) 581-0303
Entity
Organization
Contact information
Practice address
5325 S MCCOLL RD STE A, EDINBURG, TX 78539-9168
(956) 686-4422
Mailing address
5325 S MCCOLL RD STE A, EDINBURG, TX 78539-9168
(956) 686-4422
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
K3152
TX
2085R0204X
Vascular & Interventional Radiology Physician
K3152
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044283202
—
TX
05
—
145163501
—
TX
Enumeration date
10/09/2007
Last updated
10/07/2014
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