Provider Demographics
NPI:1043515166
Name:PEDRO J. PENALO, M.D., PLLC
Entity type:Organization
Organization Name:PEDRO J. PENALO, M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:J
Authorized Official - Last Name:PENALO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-447-8600
Mailing Address - Street 1:906 S BRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-7129
Mailing Address - Country:US
Mailing Address - Phone:956-447-8600
Mailing Address - Fax:956-447-0335
Practice Address - Street 1:906 S BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-7129
Practice Address - Country:US
Practice Address - Phone:956-447-8600
Practice Address - Fax:956-447-0335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7842207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty