Individual provider Active NPI

Jesus Jaime Pedraza-Banda

  • Student in an Organized Health Care Education/Training Program
  • Edinburg, TX
National Provider Identifier
1649960642
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1201 W University Dr
Edinburg, TX 78539-2909
Phone
(956) 665-7049
NPI assigned
May 11, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1201 W University Dr
Edinburg, TX 78539-2909

Mailing address

1201 W University Dr
Edinburg, TX 78539-2909
Phone (956) 665-7049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Univeristy of Texas Rio Grande Valley Med School, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1317 St Claire Blvd
Suite A5
Mission, TX 78572-6636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1649960642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W UNIVERSITY DR",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785392909",
            "telephone_number": "956-665-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W UNIVERSITY DR",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785392909",
            "telephone_number": "956-665-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRAZA-BANDA",
        "first_name": "JESUS",
        "middle_name": "JAIME",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-11",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.