Provider Demographics
NPI:1093010266
Name:HARLINGEN SPINE & NEUROSURGICAL INSTITUTE
Entity Type:Organization
Organization Name:HARLINGEN SPINE & NEUROSURGICAL INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-425-3706
Mailing Address - Street 1:597 W SESAME DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8364
Mailing Address - Country:US
Mailing Address - Phone:956-425-3706
Mailing Address - Fax:956-425-6731
Practice Address - Street 1:597 W SESAME DR
Practice Address - Street 2:SUITE D
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8364
Practice Address - Country:US
Practice Address - Phone:956-425-3706
Practice Address - Fax:956-425-6731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2139174400000X
TXL4341174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
8A1573Medicare PIN
TX8916B7Medicare PIN