Provider Demographics
NPI:1033469440
Name:SOUTH TEXAS BARIATRIC AND METABOLIC INSTITUTE, PLLC
Entity type:Organization
Organization Name:SOUTH TEXAS BARIATRIC AND METABOLIC INSTITUTE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIPE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-795-1991
Mailing Address - Street 1:6801 MCPHERSON RD
Mailing Address - Street 2:SUITE 332
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6402
Mailing Address - Country:US
Mailing Address - Phone:956-795-1991
Mailing Address - Fax:956-795-1955
Practice Address - Street 1:6801 MCPHERSON RD
Practice Address - Street 2:SUITE 332
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6402
Practice Address - Country:US
Practice Address - Phone:956-795-1991
Practice Address - Fax:956-795-1955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty