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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
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