Provider Demographics
NPI:1013210285
Name:WILMER LOJA MD PA
Entity Type:Organization
Organization Name:WILMER LOJA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILMER
Authorized Official - Middle Name:
Authorized Official - Last Name:LOJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-630-1225
Mailing Address - Street 1:PO BOX 2918
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78551-2918
Mailing Address - Country:US
Mailing Address - Phone:956-423-3335
Mailing Address - Fax:956-421-5820
Practice Address - Street 1:800 E DOVE AVE STE B
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2263
Practice Address - Country:US
Practice Address - Phone:956-630-1225
Practice Address - Fax:855-335-1068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-10
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ91712080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious DiseasesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147995801Medicaid