Individual
DR. JORGE CARLOS MAZZINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
765 PAREDES LINE RD, BROWNSVILLE, TX 78521-2524
(956) 548-0400
(956) 548-0492
Mailing address
765 PAREDES LINE RD, BROWNSVILLE, TX 78521-2524
(956) 548-0400
(956) 548-0492
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J7079
TX
2080P0208X
Pediatric Infectious Diseases Physician
J7079
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116856
SUPERIOR/CHIP
TX
05
—
133201704
—
TX
05
—
133201706
—
TX
05
—
133201707
—
TX
01
—
742857385
TAX ID
TX
Enumeration date
05/09/2006
Last updated
02/28/2013
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