Provider Demographics
NPI:1144438383
Name:ALMEDA, JOSE LUIS (MD)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:LUIS
Last Name:ALMEDA
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 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-2171
Mailing Address - Fax:956-362-2214
Practice Address - Street 1:1100 E DOVE AVE STE 201
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4681
Practice Address - Country:US
Practice Address - Phone:569-362-5433
Practice Address - Fax:569-362-2420
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2911208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203616203Medicaid
TX329176YNG9Medicare PIN
TX329176YNG9Medicare PIN
TX329176YNG9Medicare PIN
CA00A988960OtherBLUE SHIELD PIN