Provider Demographics
NPI:1083904890
Name:JUANA MARIA ESPEJO, M.D., P.A.
Entity Type:Organization
Organization Name:JUANA MARIA ESPEJO, M.D., P.A.
Other - Org Name:MY FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JUANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ESPEJO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-212-6486
Mailing Address - Street 1:PO BOX 1766
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1633
Mailing Address - Country:US
Mailing Address - Phone:956-702-6462
Mailing Address - Fax:956-702-6911
Practice Address - Street 1:2404 S CAGE BLVD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-9998
Practice Address - Country:US
Practice Address - Phone:956-702-6462
Practice Address - Fax:956-702-6911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0715207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty