Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 10315 | TX |
N | 111NI0013X | Independent Medical Examiner | 10315 | TX |
N | 111NN1001X | Nutrition | 10315 | TX |
N | 111NR0400X | Rehabilitation Chiropractor | 10315 | TX |
N | 111NS0005X | Chiropractic Sports Physician | 10315 | TX |
NPI | 1134173057 |
---|---|
Provider Name | Dr. Joseph Allen Arevalo |
First Address | Mcallen, TX 78504-3339 |
Second Address | Mcallen, TX 78504-3339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 21/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8F3299 | MEDICARE INDIVIDUAL (01) | TX |
8V4880 | BCBS (01) | TX |
TXB119095 | MEDICARE PTAN (01) | TX |
TXB119095 | MEDICARE PTAN INDIVIDUAL (01) | TX |
V09632 | (02) | TX |