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NPI 1083924658 Active Family Medicine

Quick Facts

NPI Number

1083924658

Type

Organization (NPI-2)

Status

Active

Enumeration Date

2010-10-18

Last Updated (NPPES)

2010-10-18

Primary Specialty / Taxonomy

Taxonomy	Family Medicine
Taxonomy Code	`207Q00000X`
License	H4279 TX

Practice Address

420 S BROADWAY
ELSA, TX 78543

Phone: 956-262-9940

Fax: 956-262-9960

Mailing Address

5128 N 10TH ST
MCALLEN, TX 785042834

Data sourced live from the CMS NPPES NPI Registry (npiregistry.cms.hhs.gov) and cached locally. This is a public directory lookup, not a credentialing or verification service — confirm critical details directly with NPPES or the provider.