Provider Demographics
NPI:1386914059
Name:ROBERT A. MOSQUEDA M.D.,PA.
Entity type:Organization
Organization Name:ROBERT A. MOSQUEDA M.D.,PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:MOSQUEDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-972-1234
Mailing Address - Street 1:2113 S BENTSEN RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-8460
Mailing Address - Country:US
Mailing Address - Phone:956-972-1234
Mailing Address - Fax:956-972-1423
Practice Address - Street 1:2113 S BENTSEN RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-8460
Practice Address - Country:US
Practice Address - Phone:956-972-1234
Practice Address - Fax:956-972-1423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ01452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122243702Medicaid
TX122243702Medicaid