Provider Demographics
NPI:1609881044
Name:ELIUD ACEVEDO MD P.L.L.C.
Entity Type:Organization
Organization Name:ELIUD ACEVEDO MD P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIUD
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-725-1777
Mailing Address - Street 1:1405 JACAMAN RD
Mailing Address - Street 2:STE. 101
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6194
Mailing Address - Country:US
Mailing Address - Phone:956-725-1777
Mailing Address - Fax:956-725-6510
Practice Address - Street 1:1405 JACAMAN RD
Practice Address - Street 2:STE. 101
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6194
Practice Address - Country:US
Practice Address - Phone:956-725-1777
Practice Address - Fax:956-725-6510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2437207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0038PZOtherBLUE CROSS & BLUE SHIELD
TX1689960-01Medicaid
TX0038PZOtherBLUE CROSS & BLUE SHIELD
TX00944WMedicare PIN