Provider Demographics
NPI:1457154049
Name:INULINIC
Entity type:Organization
Organization Name:INULINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:J
Authorized Official - Last Name:QUESADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-708-8008
Mailing Address - Street 1:1203 E ALTON GLOOR BLVD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-0004
Mailing Address - Country:US
Mailing Address - Phone:956-708-8008
Mailing Address - Fax:
Practice Address - Street 1:1203 E ALTON GLOOR BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-0004
Practice Address - Country:US
Practice Address - Phone:956-708-8008
Practice Address - Fax:956-542-2366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-29
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty