Healthcare Provider Details

I. General information

NPI: 1912068628
Provider Name (Legal Business Name): COMMUNITY ACTION COUNCIL OF SOUTH TEXAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 WEST MAIN ST
BENAVIDES TX
78341
US

IV. Provider business mailing address

PO BOX 98
RIO GRANDE CITY TX
78582-0098
US

V. Phone/Fax

Practice location:
  • Phone: 361-256-3322
  • Fax: 361-256-3324
Mailing address:
  • Phone: 956-487-2585
  • Fax: 956-487-2871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: MR. FRANCISCO G. ZARATE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 956-487-2585