| The Port Occupational & Medical Clinic Llc | |
|
20035 State Hwy 48 Brownsville TX 78521 | |
| (956) 431-0452 | |
| (956) 431-0454 |
| Full Name | The Port Occupational & Medical Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 20035 State Hwy 48, Brownsville, Texas |
| Authorized Official Name and Position | Antonio M Diaz (OWNER/MEDICAL DOCTOR) |
| Authorized Official Contact | 9562524969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Port Occupational & Medical Clinic Llc 20035 State Hwy 48 Brownsville TX 78521 Ph: (956) 431-0452 | The Port Occupational & Medical Clinic Llc 20035 State Hwy 48 Brownsville TX 78521 Ph: (956) 431-0452 |
| NPI Number | 1669106407 |
|---|---|
| Provider Enumeration Date | 07/15/2022 |
| Last Update Date | 03/26/2024 |
| Medicare PECOS PAC ID | 4981043049 |
|---|---|
| Medicare Enrollment ID | O20240422003320 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669106407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Antonio M Diaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952582710 PECOS PAC ID: 1254408073 Enrollment ID: I20080922000112 |
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