Provider Demographics
NPI:1154855815
Name:ARBOLEDA MOREJON, ANDRES ESTEBAN (MD)
Entity Type:Individual
Prefix:
First Name:ANDRES
Middle Name:ESTEBAN
Last Name:ARBOLEDA MOREJON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 E 6TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6608
Mailing Address - Country:US
Mailing Address - Phone:956-296-7710
Mailing Address - Fax:956-296-7705
Practice Address - Street 1:1330 E 6TH ST STE 105
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6608
Practice Address - Country:US
Practice Address - Phone:956-296-7710
Practice Address - Fax:956-296-7705
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS4912207R00000X
TX390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4122723-01Medicaid
TXH08MV75101OtherBCBS