Provider Demographics
NPI:1669803102
Name:AGUSTIN B MEGO MD PA
Entity type:Organization
Organization Name:AGUSTIN B MEGO MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AGUSTIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MEGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-686-6346
Mailing Address - Street 1:3601 BUDDY OWENS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6447
Mailing Address - Country:US
Mailing Address - Phone:956-686-6346
Mailing Address - Fax:956-686-6347
Practice Address - Street 1:3601 BUDDY OWENS AVE STE 100
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6447
Practice Address - Country:US
Practice Address - Phone:956-686-6346
Practice Address - Fax:956-686-6347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-10
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9808207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty