Provider Demographics
NPI:1588617989
Name:IZQUIERDO, ARNULFO (DO)
Entity Type:Individual
Prefix:DR
First Name:ARNULFO
Middle Name:
Last Name:IZQUIERDO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24750 STUART PLACE RD
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-6473
Mailing Address - Country:US
Mailing Address - Phone:956-412-1883
Mailing Address - Fax:956-428-1227
Practice Address - Street 1:24750 STUART PLACE RD
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-6473
Practice Address - Country:US
Practice Address - Phone:956-412-1883
Practice Address - Fax:956-428-1227
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2951207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0049HBOtherBLUE CROSS BLUE SHEILD
TX146752401Medicaid
TX146752401Medicaid
TX00781QMedicare ID - Type Unspecified