Healthcare Provider Details
I. General information
NPI: 1689882516
Provider Name (Legal Business Name): URGENT CARE-RGV M D P A CARLOS BERNAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2007
Last Update Date: 07/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
835 N EXPRESSWAY 83
BROWNSVILLE TX
78521
US
IV. Provider business mailing address
1100 N EXPRESSWAY 83, STE 3
BROWNSVILLE TX
78521
US
V. Phone/Fax
- Phone: 956-542-0300
- Fax:
- Phone: 956-542-0300
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | H2244 |
| License Number State | TX |
VIII. Authorized Official
Name:
CARLOS
V
BERNAL
Title or Position: OWNER
Credential: MD
Phone: 956-542-0300