| Quality Care Medical Center Of Kingsville Pa | |
|
510 E Caesar Ave Kingsville TX 78363 | |
| (361) 502-8588 | |
| (361) 592-2357 |
| Full Name | Quality Care Medical Center Of Kingsville Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 510 E Caesar Ave, Kingsville, Texas |
| Authorized Official Name and Position | Jerin Bryant (CO-OWNER) |
| Authorized Official Contact | 3615928588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Quality Care Medical Center Of Kingsville Pa 510 E Caesar Ave. Kingsville TX 78363 Ph: (361) 502-8588 | Quality Care Medical Center Of Kingsville Pa 510 E Caesar Ave Kingsville TX 78363 Ph: (361) 502-8588 |
| NPI Number | 1700206133 |
|---|---|
| Provider Enumeration Date | 04/24/2014 |
| Last Update Date | 04/24/2014 |
| Medicare PECOS PAC ID | 6305062936 |
|---|---|
| Medicare Enrollment ID | O20140717000373 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700206133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | E8082 (Texas) | Primary |
| 363A00000X | Physician Assistant | PA03924 (Texas) | Secondary |
| Provider Name | Octavio J Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619074929 PECOS PAC ID: 4284788431 Enrollment ID: I20110506000556 |
| Provider Name | Claudia C Cantu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861986903 PECOS PAC ID: 9032461405 Enrollment ID: I20181012000899 |
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