Individual
MR. JAIME MEDRANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
415 S. AIRPORT SUITE E, WESLACO, TX 78596
(956) 973-5024
(956) 973-5064
Mailing address
415 S. AIRPORT SUITE E, WESLACO, TX 78596
(956) 973-5024
(956) 973-5064
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K1873
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03.7773102
—
TX
01
—
K1873
TEXAS PHYSICIAN PERMIT
TX
Enumeration date
04/27/2006
Last updated
05/20/2019
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