Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | J9171 | TX |
NPI | 1396705802 |
---|---|
Provider Name | Wilmer E Loja |
First Address | Harlingen, TX 78551-2918 |
Second Address | Mcallen, TX 78504-2263 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 06/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
131255513 | (05) | TX |
C22766 | (02) | TX |