Provider Demographics
NPI:1144337627
Name:JELINEK, MICHAEL T (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:T
Last Name:JELINEK
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:PO BOX 3344
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-3344
Mailing Address - Country:US
Mailing Address - Phone:956-631-5200
Mailing Address - Fax:956-631-2812
Practice Address - Street 1:3108 CENTER POINT DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-4804
Practice Address - Country:US
Practice Address - Phone:956-631-5200
Practice Address - Fax:956-631-2812
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7167207RI0200X
MI4301046479207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81272NOtherBC/BS TX
TX81272NMedicare ID - Type Unspecified
TX81272NOtherBC/BS TX