Organization
BERNAL PEDIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME E BERNAL MD (OWNER)
(956) 630-4669
Entity
Organization
Contact information
Practice address
801 E NOLANA AVE, SUITE 11, MCALLEN, TX 78504-6104
(956) 630-4669
(956) 668-7139
Mailing address
801 E NOLANA AVE, SUITE 11, MCALLEN, TX 78504-6104
(956) 630-4669
(956) 668-7139
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K3096
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0059DF
BLUE CROSS BLUE SHIELD PROV NO.
TX
05
—
164872701
—
TX
05
—
164872702
—
TX
01
—
G04053
UPIN
TX
01
—
K3096
LICENSE NO.
TX
Enumeration date
06/04/2008
Last updated
07/07/2008
Update your record
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