Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | G7853 | TX |
Y | 2086S0122X | Plastic and Reconstructive Surgery | G7853 | TX |
NPI | 1730150707 |
---|---|
Provider Name | Dr. Armando Moncada |
First Address | Pharr, TX 78577-1614 |
Second Address | Mcallen, TX 78504-4684 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 08/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
126311304 | (05) | TX |
B24963 | (02) | TX |
G7853 | TMB (01) | TX |
R71C | BCBS (01) | TX |