Provider Demographics
NPI:1134295686
Name:PREMIER MEDICAL SERVICES
Entity Type:Organization
Organization Name:PREMIER MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER&DIRECTOR OF CLINICAL SVCS
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIOJAS
Authorized Official - Suffix:SR
Authorized Official - Credentials:CRT
Authorized Official - Phone:956-687-4767
Mailing Address - Street 1:3101 N 21ST ST
Mailing Address - Street 2:SUITE I
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-6140
Mailing Address - Country:US
Mailing Address - Phone:956-687-4767
Mailing Address - Fax:956-687-4768
Practice Address - Street 1:3101 N 21ST ST
Practice Address - Street 2:SUITE I
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-6140
Practice Address - Country:US
Practice Address - Phone:956-687-4767
Practice Address - Fax:956-687-4768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0090461332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTX14635OtherBEDDING-GERMICIDAL
TXTXD14634OtherBEDDING DISTRIBUTOR/WHOLESALER
TX188368002Medicaid
TX188386001Medicaid
TX188386001Medicaid