| Clinica San Fernando | |
|
3908 N. Jackson Rd Pharr TX 78577 | |
| (956) 502-5513 | |
| (956) 502-5514 |
| Full Name | Clinica San Fernando |
|---|---|
| Speciality | Clinic/Center |
| Location | 3908 N. Jackson Rd, Pharr, Texas |
| Authorized Official Name and Position | Nelson Loggiodice (PRESIDENT) |
| Authorized Official Contact | 9565025513 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica San Fernando 3908 N Jackson Rd Pharr TX 78577-7768 Ph: (956) 502-5513 | Clinica San Fernando 3908 N. Jackson Rd Pharr TX 78577 Ph: (956) 502-5513 |
| NPI Number | 1821317843 |
|---|---|
| Provider Enumeration Date | 06/01/2010 |
| Last Update Date | 10/02/2018 |
| Medicare PECOS PAC ID | 5799972758 |
|---|---|
| Medicare Enrollment ID | O20101203000483 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821317843 | NPI | - | NPPES |
| 217614101 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | PA03948 (Texas) | Primary |
| Provider Name | Fuad Zayed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356342190 PECOS PAC ID: 1355323544 Enrollment ID: I20040917000547 |
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