| Mario R Anzaldua Md Pa | |
|
1512 E Griffin Pkwy Ste 2 Mission TX 78572-2422 | |
| (956) 519-7088 | |
| (956) 519-9816 |
| Full Name | Mario R Anzaldua Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1512 E Griffin Pkwy Ste 2, Mission, Texas |
| Authorized Official Name and Position | Mario R Anzaldua (PRESIDENT) |
| Authorized Official Contact | 9565197088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mario R Anzaldua Md Pa 1512 E Griffin Pkwy Ste 2 Mission TX 78572-2422 Ph: (956) 519-7088 | Mario R Anzaldua Md Pa 1512 E Griffin Pkwy Ste 2 Mission TX 78572-2422 Ph: (956) 519-7088 |
| NPI Number | 1740626340 |
|---|---|
| Provider Enumeration Date | 05/22/2013 |
| Last Update Date | 10/19/2022 |
| Medicare PECOS PAC ID | 6507099942 |
|---|---|
| Medicare Enrollment ID | O20140509000154 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740626340 | NPI | - | NPPES |
| F9142 | Other | TX | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | F9142 (Texas) | Primary |
| Provider Name | Mario R Anzaldua |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528003936 PECOS PAC ID: 4981625084 Enrollment ID: I20051216000462 |
| Provider Name | Nadya P Mendez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871045112 PECOS PAC ID: 2860778842 Enrollment ID: I20170405000723 |
| Provider Name | Rosaura Rios |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649907569 PECOS PAC ID: 0648647875 Enrollment ID: I20221101001869 |
| Provider Name | Karina Sanjuanita Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811661218 PECOS PAC ID: 5496122517 Enrollment ID: I20221102002592 |
| Provider Name | Ricardo Javier Garza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497258818 PECOS PAC ID: 6204190978 Enrollment ID: I20230213000716 |
| Provider Name | Randolph Valenzuela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447938337 PECOS PAC ID: 2365899747 Enrollment ID: I20231107000094 |
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