| Multi-specialty At Renaissance | |
|
1421 N Col Rowe Blvd Ste A Mcallen TX 78501-2304 | |
| (956) 362-5030 | |
| (956) 362-5035 |
| Full Name | Multi-specialty At Renaissance |
|---|---|
| Speciality | Clinic/Center |
| Location | 1421 N Col Rowe Blvd Ste A, Mcallen, Texas |
| Authorized Official Name and Position | Ada X Gonzalez (ADMINISTRATOR) |
| Authorized Official Contact | 9563622171 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Multi-specialty At Renaissance Po Box 4767 Mcallen TX 78502-4767 Ph: (956) 362-2171 | Multi-specialty At Renaissance 1421 N Col Rowe Blvd Ste A Mcallen TX 78501-2304 Ph: (956) 362-5030 |
| NPI Number | 1578098935 |
|---|---|
| Provider Enumeration Date | 04/24/2017 |
| Last Update Date | 08/29/2022 |
| Medicare PECOS PAC ID | 6608144209 |
|---|---|
| Medicare Enrollment ID | O20170623000809 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578098935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Donald Tommy Tucker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487639324 PECOS PAC ID: 2567433212 Enrollment ID: I20040804001758 |
| Provider Name | Edna I Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487947271 PECOS PAC ID: 3173701851 Enrollment ID: I20110628000585 |
| Provider Name | Mergene A Trinidad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407233224 PECOS PAC ID: 9032425616 Enrollment ID: I20150827000352 |
| Provider Name | Rena E Atencio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619341740 PECOS PAC ID: 0547550097 Enrollment ID: I20160613000607 |
| Provider Name | Rodelyn Reyes Lucag |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467012864 PECOS PAC ID: 6709113640 Enrollment ID: I20190814003691 |
| Provider Name | Eistle Marie Reguyal Uy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962068346 PECOS PAC ID: 8224366927 Enrollment ID: I20190819003958 |
| Provider Name | Felipe Gutierrez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851896807 PECOS PAC ID: 0446657829 Enrollment ID: I20210928001606 |
| Provider Name | Arvin D Sigua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568105294 PECOS PAC ID: 7719364876 Enrollment ID: I20220512000180 |
| Provider Name | Ricardo Javier Garza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497258818 PECOS PAC ID: 6204190978 Enrollment ID: I20230213000716 |
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