Organization
JAIME MEDRANO MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME MEDRANO MD (PHYSICIAN)
(956) 973-5024
Entity
Organization
Contact information
Practice address
415 S AIRPORT DR STE E, WESLACO, TX 78596-5396
(956) 973-5024
(956) 973-5064
Mailing address
415 S AIRPORT DR STE E, WESLACO, TX 78596-5396
(956) 973-5024
(956) 973-5064
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03-7773102
—
TX
01
—
1629035423
NPI
—
01
—
K1873
TEXAS PHYSICIAN PERMIT
—
Enumeration date
08/07/2018
Last updated
07/21/2020
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