| South Texas Family Medical Center | |
|
201 Mariposa Alice TX 78332-4177 | |
| (361) 664-8811 | |
| (361) 664-8992 |
| Full Name | South Texas Family Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 201 Mariposa, Alice, Texas |
| Authorized Official Name and Position | Alejandro Lopez (PHYSICIAN) |
| Authorized Official Contact | 3616648811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Texas Family Medical Center 201 Mariposa Alice TX 78332-4177 Ph: (361) 664-8811 | South Texas Family Medical Center 201 Mariposa Alice TX 78332-4177 Ph: (361) 664-8811 |
| NPI Number | 1356462998 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 07/01/2008 |
| Medicare PECOS PAC ID | 6507964277 |
|---|---|
| Medicare Enrollment ID | O20070604000229 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356462998 | NPI | - | NPPES |
| 079902502 | Medicaid | TX | |
| 00109N | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Alejandro Lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962498121 PECOS PAC ID: 8426050618 Enrollment ID: I20070131000453 |
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