Provider Demographics
NPI:1447341250
Name:MICHAEL T. JELINEK, M.D., P.A.
Entity type:Organization
Organization Name:MICHAEL T. JELINEK, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:JELINEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-631-5200
Mailing Address - Street 1:P.O. BOX 3344
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502
Mailing Address - Country:US
Mailing Address - Phone:956-631-5200
Mailing Address - Fax:956-631-2812
Practice Address - Street 1:3108 CENTER POINTE DRIVE
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539
Practice Address - Country:US
Practice Address - Phone:956-631-5200
Practice Address - Fax:956-631-2812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CI9962OtherRAILROAD MEDICARE
TX00739KOtherBC/BS OF TX GROUP ID#
TX00739KMedicare ID - Type UnspecifiedMEDICARE GROUP PROVIDER #