Provider Demographics
NPI:1578639340
Name:SPINETTI, NELSON JESUS (MD)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:JESUS
Last Name:SPINETTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3083
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-3083
Mailing Address - Country:US
Mailing Address - Phone:956-682-2244
Mailing Address - Fax:956-682-5544
Practice Address - Street 1:2707 CORNERSTONE BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8464
Practice Address - Country:US
Practice Address - Phone:956-682-2244
Practice Address - Fax:956-682-5544
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-25
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL85162080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165172102Medicaid
TX192121501Medicaid
TX192121501Medicaid