| |
1200 N Bedell Ave Del Rio TX 78840-4491 | |
(830) 774-4580 | |
Not Available |
Full Name | |
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Speciality | Internal Medicine |
Location | 1200 N Bedell Ave, Del Rio, Texas |
Authorized Official Name and Position | Adrian F Larson (SENIOR DIRECTOR OF OUPATIENT SERVIC) |
Authorized Official Contact | 8307744580 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 437 San Antonio TX 78292-0437 Ph: (210) 558-6288 | 1200 N Bedell Ave Del Rio TX 78840-4491 Ph: (830) 774-4580 |
NPI Number | 1912211913 |
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Provider Enumeration Date | 08/02/2010 |
Last Update Date | 03/06/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912211913 | NPI | - | NPPES |
281839501 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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