Healthcare Provider Details

I. General information

NPI: 1952337263
Provider Name (Legal Business Name): SOUTH TEXAS RURAL HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S STEWART
COTULLA TX
78014
US

IV. Provider business mailing address

PO BOX 599
COTULLA TX
78014
US

V. Phone/Fax

Practice location:
  • Phone: 830-879-3048
  • Fax: 830-879-6390
Mailing address:
  • Phone: 830-879-3047
  • Fax: 830-879-2940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MS. MYRTA GARCIA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 830-879-3047