Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 28777 | TX |
NPI | 1104173087 |
---|---|
Provider Name | Wilmer Paul Orjuela |
First Address | Mcallen, TX 78504-4141 |
Second Address | Mcallen, TX 78504-4141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2012 |
Last Update Date | 09/04/2021 |