Provider Demographics
NPI:1932389756
Name:SOUTHERN BONE AND JOINT CENTER ASSOCIATES
Entity Type:Organization
Organization Name:SOUTHERN BONE AND JOINT CENTER ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:E
Authorized Official - Last Name:TIJMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-687-2032
Mailing Address - Street 1:PO BOX 20474
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4099
Mailing Address - Country:US
Mailing Address - Phone:956-687-2032
Mailing Address - Fax:956-971-9306
Practice Address - Street 1:320 N MCCOLL RD
Practice Address - Street 2:SUITE A
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-9348
Practice Address - Country:US
Practice Address - Phone:956-687-2032
Practice Address - Fax:956-971-9306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00J78XMedicare PIN