Provider Demographics
NPI:1538265913
Name:ESPEJO, JUANA MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:JUANA
Middle Name:MARIA
Last Name:ESPEJO
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1590
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1627
Mailing Address - Country:US
Mailing Address - Phone:956-212-6486
Mailing Address - Fax:956-702-6911
Practice Address - Street 1:2404 S CAGE BLVD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6716
Practice Address - Country:US
Practice Address - Phone:956-212-6486
Practice Address - Fax:956-702-6911
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2015-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM07151710I1003X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM0715OtherMEDICAL LICENSE