Individual provider · NPI-1

Luis A Medina

Internal Medicine · Port Arthur, TX

NPI number1164418752
StatusActive
Last updated in NPPESSep 28, 2013

Details

NPI
1164418752
Entity type
Individual (NPI-1)
Name
Luis A Medina
Sex
Male
Sole proprietor
Yes
Enumeration date
Sep 20, 2005
Last updated
Sep 28, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal MedicineK6649TXYes

Practice location

3800 Highway 365
#119
Port Arthur, TX 77642-7526

Phone 409-722-6100 · Fax 409-722-6109

Mailing address

Po Box 3377
Port Arthur, TX 77643-3377

Phone 409-722-6100 · Fax 409-722-6109

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