Provider Demographics
NPI:1043490063
Name:MONZER H YAZJI MD AND ASSOCIATES
Entity Type:Organization
Organization Name:MONZER H YAZJI MD AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLESCAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-468-2999
Mailing Address - Street 1:502 S CLOSNER BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-4660
Mailing Address - Country:US
Mailing Address - Phone:956-292-0100
Mailing Address - Fax:956-383-1906
Practice Address - Street 1:502 S CLOSNER BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-4660
Practice Address - Country:US
Practice Address - Phone:956-292-0100
Practice Address - Fax:956-383-1906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111949703Medicaid