Provider Demographics
NPI:1982984209
Name:TAMEZ, MIGUEL ARMANDO (MPAS, PA-C)
Entity Type:Individual
Prefix:MR
First Name:MIGUEL
Middle Name:ARMANDO
Last Name:TAMEZ
Suffix:
Gender:M
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:349 S HELEN MOORE RD APT 9203
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-9094
Mailing Address - Country:US
Mailing Address - Phone:956-371-5325
Mailing Address - Fax:
Practice Address - Street 1:80 FORT BROWN ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-4956
Practice Address - Country:US
Practice Address - Phone:956-371-5325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX07273363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant