Full Name | |
---|---|
Speciality | Clinic/center - Multi-specialty |
Location | 101 South Broadway, Elsa, Texas |
Authorized Official Name and Position | Jose Fernando Pena (MEDICAL DIRECTOR) |
Authorized Official Contact | 9562621304 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 3706 Mcallen TX 78502-3706 Ph: (956) 262-1304 | 101 South Broadway Elsa TX 78543 Ph: (956) 262-1304 |
NPI Number | 1770510661 |
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Provider Enumeration Date | 06/27/2006 |
Last Update Date | 12/14/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770510661 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | J9264 (Texas) | Primary |
Luna Pediatric And Family Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 322 S. Broadway, Suite 4, Elsa, TX 78543 Phone: 956-490-9190 | |
Renuevate Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 119 Retama Street, Suite C, Elsa, TX 78543 Phone: 956-567-2236 Fax: 956-567-2013 | |