Individual
EDGAR J JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-1133
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME91275
FL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
ME91275
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271469800
—
FL
Enumeration date
12/02/2005
Last updated
09/17/2020
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