Provider Demographics
NPI:1831530922
Name:MCALLEN ORTHOPEDIC INSTITUTE
Entity type:Organization
Organization Name:MCALLEN ORTHOPEDIC INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:R
Authorized Official - Last Name:FULP
Authorized Official - Suffix:III
Authorized Official - Credentials:DO
Authorized Official - Phone:956-631-6109
Mailing Address - Street 1:2501 BUDDY OWENS AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-5427
Mailing Address - Country:US
Mailing Address - Phone:956-631-6109
Mailing Address - Fax:956-631-2125
Practice Address - Street 1:2501 BUDDY OWENS AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-5427
Practice Address - Country:US
Practice Address - Phone:956-631-6109
Practice Address - Fax:956-631-2125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129886108Medicaid
8F5424Medicare PIN
TX129886108Medicaid