Provider Demographics
NPI:1932634649
Name:ZAMORA-LEGOFF, JORGE ALEJANDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:ALEJANDRO
Last Name:ZAMORA-LEGOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 RED RIVER DR
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-7454
Mailing Address - Country:US
Mailing Address - Phone:956-624-2469
Mailing Address - Fax:
Practice Address - Street 1:2102 TREASURE HILLS BLVD
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8736
Practice Address - Country:US
Practice Address - Phone:956-296-1491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10059527207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX664460OtherTEXAS MEDICAL BOARD - PHYSICIAN IN TRAINING