Provider Demographics
NPI:1699851873
Name:PEDRO M ARRAZOLA MDPA
Entity type:Organization
Organization Name:PEDRO M ARRAZOLA MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ARRAZOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-618-5555
Mailing Address - Street 1:5114 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2834
Mailing Address - Country:US
Mailing Address - Phone:956-618-5555
Mailing Address - Fax:956-618-0329
Practice Address - Street 1:5114 NORTH 10TH
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504
Practice Address - Country:US
Practice Address - Phone:956-618-5555
Practice Address - Fax:956-618-0329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8538207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0331266-02Medicaid
TX00Y950OtherGROUP PTAN
TX00Y950Medicare PIN
TXE65059Medicare UPIN