Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | E9354 | TX |
NPI | 1033127733 |
---|---|
Provider Name | Felix F Regueira |
First Address | Victoria, TX 77901-2767 |
Second Address | Victoria, TX 77901-2767 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 24/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0059DJ | BLUE CROSS BLUE SHIELD (01) | TX |
060378901 | (05) | TX |
092297101 | (05) | TX |
092298102 | (05) | TX |
4331614 | AETNA (01) | TX |
82920X | BLUE CROSS BLUE SHIELD (01) | TX |
G33865 | (02) | TX |