Provider Demographics
NPI:1477859627
Name:SEGUNDO LIZARDO M.D.P.A.
Entity Type:Organization
Organization Name:SEGUNDO LIZARDO M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEGUNDO
Authorized Official - Middle Name:L
Authorized Official - Last Name:LIZARDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-514-1643
Mailing Address - Street 1:208 STARR ST
Mailing Address - Street 2:
Mailing Address - City:MERCEDES
Mailing Address - State:TX
Mailing Address - Zip Code:78570-2711
Mailing Address - Country:US
Mailing Address - Phone:956-514-1643
Mailing Address - Fax:956-514-2564
Practice Address - Street 1:208 STARR ST
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-2711
Practice Address - Country:US
Practice Address - Phone:956-514-1643
Practice Address - Fax:956-514-2564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty