Provider Demographics
NPI:1114268513
Name:HERRERA LIRIO, EDUARDO JOSE (MD)
Entity type:Individual
Prefix:
First Name:EDUARDO
Middle Name:JOSE
Last Name:HERRERA LIRIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 RETAMA ST STE A
Mailing Address - Street 2:
Mailing Address - City:ELSA
Mailing Address - State:TX
Mailing Address - Zip Code:78543-3005
Mailing Address - Country:US
Mailing Address - Phone:956-255-4433
Mailing Address - Fax:
Practice Address - Street 1:119 RETAMA ST STE A
Practice Address - Street 2:
Practice Address - City:ELSA
Practice Address - State:TX
Practice Address - Zip Code:78543-3005
Practice Address - Country:US
Practice Address - Phone:956-255-4433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-09
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE30086207V00000X
390200000X
TXU9952207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program