Provider Demographics
NPI:1417159542
Name:GEORGE P AMEGIN DO PA
Entity Type:Organization
Organization Name:GEORGE P AMEGIN DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:AMEGIN
Authorized Official - Suffix:SR
Authorized Official - Credentials:DO
Authorized Official - Phone:956-318-1400
Mailing Address - Street 1:2005 WEST UNIVERSITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-2831
Mailing Address - Country:US
Mailing Address - Phone:956-318-1400
Mailing Address - Fax:956-318-0022
Practice Address - Street 1:2005 WEST UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-2831
Practice Address - Country:US
Practice Address - Phone:956-318-1400
Practice Address - Fax:956-318-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8566 (DR. AMEGIN)207W00000X
TXF4841 (DR. GOEL)207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX029806901Medicaid
TX079935501Medicaid
TX133112606Medicaid
TX5019450001Medicare NSC