Provider Demographics
NPI:1780705087
Name:JOSE M. LONGORIA III, DC PA
Entity type:Organization
Organization Name:JOSE M. LONGORIA III, DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:LONGORIA
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:956-792-3829
Mailing Address - Street 1:3020 N FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-8886
Mailing Address - Country:US
Mailing Address - Phone:956-792-3829
Mailing Address - Fax:956-687-7713
Practice Address - Street 1:3515 N 10TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-1931
Practice Address - Country:US
Practice Address - Phone:956-687-7705
Practice Address - Fax:956-687-7713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9688111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty