Organization
M BANDEIRA TEIXEIRA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAURICIO BANDEIRA TEIXEIRA M.D. (PROPRIETOR)
(361) 664-5535
Entity
Organization
Contact information
Practice address
312 E 2ND ST, ALICE, TX 78332-4806
(361) 664-5535
(361) 664-1797
Mailing address
312 E 2ND ST, P. O. BOX 1211, ALICE, TX 78332-4806
(361) 664-5535
(361) 664-1797
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033293345
NPI 1033293345
TX
05
—
208600000X
—
TX
Enumeration date
11/24/2009
Last updated
05/03/2010
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