| Centro San Vicente | |
|
13017 Perico St San Elizario TX 79849-1517 | |
| (915) 851-0999 | |
| (915) 851-6060 |
| Full Name | Centro San Vicente |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 13017 Perico St, San Elizario, Texas |
| Authorized Official Name and Position | Jose Luna (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9152250670 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro San Vicente Po Box 1517 San Elizario TX 79849-1517 Ph: (915) 851-0999 | Centro San Vicente 13017 Perico St San Elizario TX 79849-1517 Ph: (915) 851-0999 |
| NPI Number | 1780761452 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 04/30/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780761452 | NPI | - | NPPES |
| 130880102 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Project Vida Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Herring Road, San Elizario, TX 79849 Phone: 915-465-1191 | |
Centro De Salud Familiar La Fe, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12101 Socorro Rd., San Elizario, TX 79849 Phone: 915-851-5519 Fax: 915-851-0558 |