| Rio Grande Oral & Maxillofacial Surgery, P.c. | |
|
1622 N Ed Carey Dr Harlingen TX 78550-8286 | |
| (956) 428-4258 | |
| (956) 428-4292 |
| Full Name | Rio Grande Oral & Maxillofacial Surgery, P.c. |
|---|---|
| Speciality | Dentist |
| Location | 1622 N Ed Carey Dr, Harlingen, Texas |
| Authorized Official Name and Position | Karl F Frey (MANAGING PARTNER) |
| Authorized Official Contact | 9564284258 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rio Grande Oral & Maxillofacial Surgery, P.c. 1622 N Ed Carey Dr Harlingen TX 78550-8286 Ph: (956) 428-4258 | Rio Grande Oral & Maxillofacial Surgery, P.c. 1622 N Ed Carey Dr Harlingen TX 78550-8286 Ph: (956) 428-4258 |
| NPI Number | 1417088972 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 01/08/2014 |
| Medicare PECOS PAC ID | 3678743523 |
|---|---|
| Medicare Enrollment ID | O20110831000789 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417088972 | NPI | - | NPPES |
| 286457101 | Medicaid | TX | |
| 009746101 | Medicaid | TX | |
| 009746103 | Medicaid | TX | |
| 080437901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Karl F Frey |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1821091398 PECOS PAC ID: 9436248804 Enrollment ID: I20110831000814 |
| Provider Name | Auxillian Luciano Stroia |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1669547964 PECOS PAC ID: 0143481242 Enrollment ID: I20120417000668 |
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