Mederos, Ivan A
Mederos, Ivan A is an individual health care provider with primary practice located at 1710 E Saunders St Suite B-375, Laredo TX 78041-5443. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Mederos, Ivan A can be contacted via phone (956) 795-8297.Contact Information
Primary practice address
1710 E Saunders St Suite B-375
Laredo TX 78041-5443
Phone: (956) 795-8297
Fax: (956) 794-8888
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | J7581 | Texas |
Profile Details
| NPI number | 1205809258 |
|---|---|
| LBN Legal business name | Mederos, Ivan A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 9th, 2006 |
| Last updated | Sep 16th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205809258 | NPPES |
| Texas | MEDICAID | 102583501 |
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