Provider Demographics
NPI:1134182488
Name:VEGA, ROLANDO E (MD)
Entity type:Individual
Prefix:DR
First Name:ROLANDO
Middle Name:E
Last Name:VEGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7121 S PADRE ISLAND DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412
Mailing Address - Country:US
Mailing Address - Phone:361-993-6000
Mailing Address - Fax:361-985-1152
Practice Address - Street 1:7121 S PADRE ISLAND DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412
Practice Address - Country:US
Practice Address - Phone:361-993-6000
Practice Address - Fax:361-985-1152
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1487207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX197790201Medicaid
PR40636Medicare UPIN
PR83859Medicare ID - Type Unspecified
TX8L4156Medicare PIN