Healthcare Provider Details

I. General information

NPI: 1386703163
Provider Name (Legal Business Name): FRANCISCO AMBRIZ JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2006
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2534 BOCA CHICA BLVD
BROWNSVILLE TX
78521-3496
US

IV. Provider business mailing address

805 GRAYSON AVE
MCALLEN TX
78504-6579
US

V. Phone/Fax

Practice location:
  • Phone: 956-546-2000
  • Fax:
Mailing address:
  • Phone: 945-457-1657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA00003
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: