Provider Demographics
NPI:1790171635
Name:TIJERINA, LIZANDRO JR
Entity Type:Individual
Prefix:
First Name:LIZANDRO
Middle Name:
Last Name:TIJERINA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 BEECH AVE
Mailing Address - Street 2:SUITE 131
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-5193
Mailing Address - Country:US
Mailing Address - Phone:956-800-5502
Mailing Address - Fax:956-800-5503
Practice Address - Street 1:1418 BEECH AVE
Practice Address - Street 2:SUITE 131
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5193
Practice Address - Country:US
Practice Address - Phone:956-800-5502
Practice Address - Fax:956-800-5503
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care