Provider Demographics
NPI:1699976548
Name:MCALLEN NEUROSURGICAL CENTER, P.A.
Entity type:Organization
Organization Name:MCALLEN NEUROSURGICAL CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROSURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:HUMBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:TIJERINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-631-8717
Mailing Address - Street 1:PO BOX 4889
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-4889
Mailing Address - Country:US
Mailing Address - Phone:956-631-8717
Mailing Address - Fax:956-630-2292
Practice Address - Street 1:1200 S COL ROWE BLVD
Practice Address - Street 2:SUITE 5-A
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2956
Practice Address - Country:US
Practice Address - Phone:956-631-8717
Practice Address - Fax:956-630-2292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7359174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID NUMBER USE POR P.I
TXB26985Medicare UPIN