Provider Demographics
NPI:1013037423
Name:MELVA PALACIOS, M.D., PA
Entity Type:Organization
Organization Name:MELVA PALACIOS, M.D., PA
Other - Org Name:PALACIOS & CASSO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELVA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALACIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-383-4157
Mailing Address - Street 1:2722 W CANTON RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6632
Mailing Address - Country:US
Mailing Address - Phone:956-383-4157
Mailing Address - Fax:956-383-5457
Practice Address - Street 1:2722 W CANTON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-6632
Practice Address - Country:US
Practice Address - Phone:956-383-4157
Practice Address - Fax:956-383-5457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7837207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175155401Medicaid
TX0052MYOtherBCBS OF TEXAS
TX175155401Medicaid