| Clinica Sagrado Corazon | |
|
3401 W Mile 5 Rd Ste 1 Mission TX 78574-5177 | |
| (956) 778-2032 | |
| (956) 580-2677 |
| Full Name | Clinica Sagrado Corazon |
|---|---|
| Speciality | Clinic/Center |
| Location | 3401 W Mile 5 Rd Ste 1, Mission, Texas |
| Authorized Official Name and Position | Pablo Olmedo (OWNER) |
| Authorized Official Contact | 9565802145 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Sagrado Corazon 3401 W Mile 5 Rd Ste 1 Mission TX 78574-5177 Ph: (956) 778-2032 | Clinica Sagrado Corazon 3401 W Mile 5 Rd Ste 1 Mission TX 78574-5177 Ph: (956) 778-2032 |
| NPI Number | 1770860116 |
|---|---|
| Provider Enumeration Date | 11/14/2011 |
| Last Update Date | 02/12/2014 |
| Medicare PECOS PAC ID | 8921258435 |
|---|---|
| Medicare Enrollment ID | O20121018000302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770860116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | M8225 (Texas) | Primary |
| Provider Name | Pablo J Olmedo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609057074 PECOS PAC ID: 1254417371 Enrollment ID: I20080328000433 |
| Provider Name | Elizabeth R Mills-reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144593138 PECOS PAC ID: 6002071669 Enrollment ID: I20210910000168 |
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