Provider Demographics
NPI:1861687667
Name:ROBERT SEPULVEDA MD
Entity type:Organization
Organization Name:ROBERT SEPULVEDA MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-968-9517
Mailing Address - Street 1:901 E 6TH
Mailing Address - Street 2:STE 5
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6449
Mailing Address - Country:US
Mailing Address - Phone:956-968-9517
Mailing Address - Fax:956-968-9518
Practice Address - Street 1:901 E 6TH
Practice Address - Street 2:STE 5
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6449
Practice Address - Country:US
Practice Address - Phone:956-968-9517
Practice Address - Fax:956-968-9518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3522207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty