Provider Demographics
NPI:1689858706
Name:TORRES-REVERON, JUAN ED (MD/ PHD)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:ED
Last Name:TORRES-REVERON
Suffix:
Gender:M
Credentials:MD/ PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-8500
Mailing Address - Fax:956-362-8529
Practice Address - Street 1:5519 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5563
Practice Address - Country:US
Practice Address - Phone:956-362-8500
Practice Address - Fax:956-362-8505
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU8251207T00000X, 207T00000X, 207T00000X
OH35.126983207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery