Provider Demographics
NPI:1851388649
Name:HARLINGEN BONE & JOINT CLINIC, P.A.
Entity Type:Organization
Organization Name:HARLINGEN BONE & JOINT CLINIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:KEILLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-423-5033
Mailing Address - Street 1:1801 N ED CAREY DR
Mailing Address - Street 2:STE. A
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8268
Mailing Address - Country:US
Mailing Address - Phone:956-423-5033
Mailing Address - Fax:956-412-3028
Practice Address - Street 1:1801 N ED CAREY DR
Practice Address - Street 2:STE. A
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8268
Practice Address - Country:US
Practice Address - Phone:956-423-5033
Practice Address - Fax:956-412-3028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD6052174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX091574601Medicaid
TX00L35BOtherBCBS OF TX GRP PROV #
TX129821100OtherVALLEY HEALTH PLAN PROV #
TX200005753OtherRAILROAD MEDICARE PROV#
TX78550A002OtherTRICARE PROV. #
TX091574602Medicaid
TX78550A002OtherTRICARE PROV. #
TX129821100OtherVALLEY HEALTH PLAN PROV #