MEDICARE: PEDIATRIC HEART CLINIC OF MCALLEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0202X	Pediatric Cardiology Physician

General Provider Information

NPI Number	:	1427295948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRIC HEART CLINIC OF MCALLEN

Provider Business Mailing Address
First Line	:	5506 S JACKSON RD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-9902
Country	:	US
Telephone Number	:	956-661-0066
Fax Number	:	956-661-0071

Provider Business Practice Location Address
First Line	:	5506 S JACKSON RD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-9902
Country	:	US
Telephone Number	:	956-661-0066
Fax Number	:	956-661-0071

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ASSAD I ALHROOB
Credential	:	MD
Telephone Number	:	956-661-0066

Provider Enumeration Date	:	01/21/2009
Last Update Date	:	03/11/2009

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