Provider Demographics
NPI:1649417627
Name:BERROCAL O'HIGGINS, MARIO ISAAC (MD)
Entity Type:Individual
Prefix:
First Name:MARIO
Middle Name:ISAAC
Last Name:BERROCAL O'HIGGINS
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 1:1200 E RIDGE RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1527
Mailing Address - Country:US
Mailing Address - Phone:956-630-5530
Mailing Address - Fax:956-630-5954
Practice Address - Street 1:1200 E RIDGE RD
Practice Address - Street 2:SUITE 8
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1527
Practice Address - Country:US
Practice Address - Phone:956-630-5530
Practice Address - Fax:956-630-5954
Is Sole Proprietor?:No
Enumeration Date:2009-01-13
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL125051146207R00000X
TXN7525207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine