Stm Primary Care Clinic | |
901 E Esperanza Ave Mcallen TX 78501-1424 | |
(956) 688-8181 | |
(956) 688-8034 |
Full Name | Stm Primary Care Clinic |
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Speciality | Family Medicine |
Location | 901 E Esperanza Ave, Mcallen, Texas |
Authorized Official Name and Position | Vinnie D Kallumadanda (MEDICAL DOCTOR/ OWNER) |
Authorized Official Contact | 9566888181 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Stm Primary Care Clinic 901 E Esperanza Ave Mcallen TX 78501-1424 Ph: (956) 688-8181 | Stm Primary Care Clinic 901 E Esperanza Ave Mcallen TX 78501-1424 Ph: (956) 688-8181 |
NPI Number | 1548501984 |
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Provider Enumeration Date | 03/11/2013 |
Last Update Date | 08/02/2013 |
Medicare PECOS PAC ID | 5890937841 |
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Medicare Enrollment ID | O20130805000376 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548501984 | NPI | - | NPPES |
1912169459 | Other | INDIVIDUAL NPI | |
1588712848 | Other | INDIVIDUAL NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | N0872 (Texas) | Primary |
207Q00000X | Family Medicine | M5733 (Texas) | Secondary |
Provider Name | Vinnie D Kallumadanda |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1912169459 PECOS PAC ID: 2860547015 Enrollment ID: I20090911000401 |
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