Provider Demographics
NPI:1326111030
Name:PAGAN-HEMER, TERESITA MONSERRATE (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESITA
Middle Name:MONSERRATE
Last Name:PAGAN-HEMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 S BRYAN RD
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-6672
Mailing Address - Country:US
Mailing Address - Phone:956-580-3100
Mailing Address - Fax:956-585-9921
Practice Address - Street 1:1500 S BRYAN RD
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-6672
Practice Address - Country:US
Practice Address - Phone:956-580-3100
Practice Address - Fax:956-585-9921
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7075208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
4109948OtherECFMG
TX150144701Medicaid
TX150144701Medicaid