1255386686 NPI number — RGV HEART SPECIALISTS LLP

Table of content: (NPI 1255386686)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255386686 NPI number — RGV HEART SPECIALISTS LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RGV HEART SPECIALISTS LLP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
RIO GRANDE HEART SPECIALISTS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255386686
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4882B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77210-4882
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-661-0003
Provider Business Mailing Address Fax Number:
956-687-7917

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 E RIDGE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCALLEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78503-1346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-682-1888
Provider Business Practice Location Address Fax Number:
956-928-1173
Provider Enumeration Date:
05/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RAMIREZ
Authorized Official First Name:
NORMAN
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
956-682-1888

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 148058401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0032BV . This is a "BLUE CROSS/SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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