Provider Demographics
NPI:1386996775
Name:MEDLAND ASSOCIATES
Entity type:Organization
Organization Name:MEDLAND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:OLADAYO
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANUSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-230-2933
Mailing Address - Street 1:400 W US HIGHWAY 77
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-5148
Mailing Address - Country:US
Mailing Address - Phone:956-230-2933
Mailing Address - Fax:956-230-2935
Practice Address - Street 1:400 W US HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-5148
Practice Address - Country:US
Practice Address - Phone:956-230-2933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty