Provider Demographics
NPI:1851373757
Name:POPEK, MONIQUE M (MD)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:M
Last Name:POPEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4706
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-4706
Mailing Address - Country:US
Mailing Address - Phone:956-686-3752
Mailing Address - Fax:956-686-5414
Practice Address - Street 1:520 S 15TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5202
Practice Address - Country:US
Practice Address - Phone:956-686-3752
Practice Address - Fax:956-686-5414
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9041207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081934401Medicaid
TXC20596Medicare UPIN
TX081934401Medicaid