Tijerino, Max T
Tijerino, Max T is an individual health care provider with primary practice located at 703 S Fleishel Ave Ste 5000, Tyler TX 75701-2015. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Tijerino, Max T can be contacted via phone (903) 525-2992.Contact Information
Primary practice address
703 S Fleishel Ave Ste 5000
Tyler TX 75701-2015
Phone: (903) 525-2992
Fax: (903) 525-2685
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | Alabama | |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA10936 | Texas |
Profile Details
| NPI number | 1649721366 |
|---|---|
| LBN Legal business name | Tijerino, Max T |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 18th, 2016 |
| Last updated | Feb 10th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649721366 | NPPES |
| Texas | Other | 75-2616977-039 | TRICARE |
| Texas | Other | 75-2616977-123 | TRICARE |
| Texas | Other | 88117MA | TRICARE |
| Texas | MEDICAID | 365425301 | TRICARE |
| Texas | Other | P01762498 | TRICARE |
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