Medina, Luis A
Medina, Luis A is an sole proprietor health care provider with primary practice located at 3800 Highway 365 #119, Port Arthur TX 77642-7526. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Medina, Luis A can be contacted via phone (409) 722-6100.Contact Information
Primary practice address
3800 Highway 365 #119
Port Arthur TX 77642-7526
Phone: (409) 722-6100
Fax: (409) 722-6109
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | K6649 | Texas |
Profile Details
| NPI number | 1164418752 |
|---|---|
| LBN Legal business name | Medina, Luis A |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 20th, 2005 |
| Last updated | Sep 28th, 2013 - about 11 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 | 1164418752 | NPPES |
| Texas | MEDICAID | 029674101 |
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