Provider Demographics
NPI:1396976825
Name:ROXANA PAGAN-MALDONADO MD PA
Entity type:Organization
Organization Name:ROXANA PAGAN-MALDONADO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROXANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGAN-MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-421-5202
Mailing Address - Street 1:512 VICTORIA LN
Mailing Address - Street 2:SUITE#4
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-3226
Mailing Address - Country:US
Mailing Address - Phone:956-421-5202
Mailing Address - Fax:956-421-5238
Practice Address - Street 1:512 VICTORIA LN
Practice Address - Street 2:SUITE#4
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-3226
Practice Address - Country:US
Practice Address - Phone:956-421-5202
Practice Address - Fax:956-421-5238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5435207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty