Provider Demographics
NPI:1538167390
Name:TREMOR, ISNARDO E (MD)
Entity type:Individual
Prefix:DR
First Name:ISNARDO
Middle Name:E
Last Name:TREMOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:108 HICKORY DRIVE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340
Mailing Address - Country:US
Mailing Address - Phone:936-291-2116
Mailing Address - Fax:936-435-7824
Practice Address - Street 1:123 MEDICAL PARK LN STE A
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4981
Practice Address - Country:US
Practice Address - Phone:936-291-2116
Practice Address - Fax:936-435-7824
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1707207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX104862102Medicaid
TX8DT119OtherBCBS
TX285690YRW3Medicare PIN
TX88213KMedicare PIN
TX104862102Medicaid