Basic Information
| Provider Information | |||||||||
| NPI: | 1730192816 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PALLAPATI | ||||||||
| FirstName: | JOEL | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2101 PEASE ST | ||||||||
| Address2: | SUITE 1G | ||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785508307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9563894710 | ||||||||
| FaxNumber: | 9563893537 | ||||||||
| Practice Location | |||||||||
| Address1: | 2101 PEASE ST | ||||||||
| Address2: | SUITE 1G | ||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785508307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9563896565 | ||||||||
| FaxNumber: | 9563896567 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2006 | ||||||||
| LastUpdateDate: | 04/04/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | K1895 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 045876202 | 05 | TX | MEDICAID | 045876201 | 05 | TX | MEDICAID |