Provider Demographics
NPI:1518168772
Name:BEJARANO, JOSE DARIO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:DARIO
Last Name:BEJARANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOSE
Other - Middle Name:DARIO
Other - Last Name:BEJARANO LOPEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5111 N 10TH ST # 230
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2835
Mailing Address - Country:US
Mailing Address - Phone:956-969-1313
Mailing Address - Fax:956-969-1322
Practice Address - Street 1:910 E 8TH ST STE 3
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-4346
Practice Address - Country:US
Practice Address - Phone:956-969-1313
Practice Address - Fax:956-969-1322
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7034207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX194007406Medicaid
TX194007408Medicaid