Provider Demographics
NPI:1942243951
Name:TAPANGAN PEDIATRICS
Entity Type:Organization
Organization Name:TAPANGAN PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSELLER
Authorized Official - Middle Name:
Authorized Official - Last Name:TAPANGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-399-9300
Mailing Address - Street 1:1653 W US HIGHWAY 77
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-4127
Mailing Address - Country:US
Mailing Address - Phone:956-399-9300
Mailing Address - Fax:956-399-3907
Practice Address - Street 1:1653 W US HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-4127
Practice Address - Country:US
Practice Address - Phone:956-399-9300
Practice Address - Fax:956-399-3907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID NO.