Basic Information
| Provider Information | |||||||||
| NPI: | 1598094088 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HARLINGEN PHYSICIAN NETWORK, INC, | ||||||||
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| OtherOrganizationName: | ELDO E FREZZA, M.D. | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 614 MACO DR | ||||||||
| Address2: | |||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785508450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9564409110 | ||||||||
| FaxNumber: | 9564489808 | ||||||||
| Practice Location | |||||||||
| Address1: | 614 MACO DR | ||||||||
| Address2: | |||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785508450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9564409110 | ||||||||
| FaxNumber: | 9564489808 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2009 | ||||||||
| LastUpdateDate: | 12/14/2009 | ||||||||
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| AuthorizedOfficialLastName: | EASTHAM | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9563896565 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | SR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | N4242 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.