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640 E Bravo Blvd Roma TX 78584-5720 | |
(956) 849-2176 | |
(956) 849-3439 |
Full Name | |
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Speciality | Family Medicine |
Location | 640 E Bravo Blvd, Roma, Texas |
Authorized Official Name and Position | Raymond P Mussett (OWNER) |
Authorized Official Contact | 9568492176 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1120 Roma TX 78584-1120 Ph: (956) 849-2176 | 640 E Bravo Blvd Roma TX 78584-5720 Ph: (956) 849-2176 |
NPI Number | 1841354628 |
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Provider Enumeration Date | 12/19/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1841354628 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | E8752 (Texas) | Secondary |
207Q00000X | Family Medicine | M1437 (Texas) | Primary |
Nuestra Clinica Del Valle Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2891 E Grant St, Roma, TX 78584 Phone: 956-849-2100 Fax: 956-787-8915 | |