Provider Demographics
NPI:1184761728
Name:PHYSICIANS EDUCATIONAL FOUNDATION
Entity type:Organization
Organization Name:PHYSICIANS EDUCATIONAL FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:J
Authorized Official - Last Name:NARANJO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-687-6155
Mailing Address - Street 1:205 E TORONTO AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1209
Mailing Address - Country:US
Mailing Address - Phone:956-687-6155
Mailing Address - Fax:956-618-0451
Practice Address - Street 1:205 E TORONTO AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1209
Practice Address - Country:US
Practice Address - Phone:956-687-6155
Practice Address - Fax:956-618-0451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX017744601Medicaid
TX081765201Medicaid
TX022947801Medicaid
TXBF19Medicare ID - Type Unspecified