Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | M3018 | TX |
N | 111NI0900X | Internist | M3018 | TX |
N | 207RC0000X | Internist - Cardiovascular Disease | M3018 | TX |
Y | 207RI0011X | Interventional Cardiology | M3018 | TX |
NPI | 1104956119 |
---|---|
Provider Name | Dr. Dileep Vijay Menon |
First Address | Mcallen, TX 78502-4449 |
Second Address | Rio Grande City, TX 78582-6725 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 06/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
285658501 | (05) | TX |