Healthcare Provider Details

I. General information

NPI: 1972781318
Provider Name (Legal Business Name): HERBERT I GARFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 07/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 NORTH GIRAUD
COTULLA TX
78014-3113
US

IV. Provider business mailing address

408 NORTH GIRAUD
COTULLA TX
78014-3113
US

V. Phone/Fax

Practice location:
  • Phone: 830-879-2279
  • Fax: 830-879-2235
Mailing address:
  • Phone: 830-879-2279
  • Fax: 830-879-2235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberD4487
License Number StateTX

VIII. Authorized Official

Name: DR. HERBERT I GARFIELD
Title or Position: OWNER
Credential: M.D.
Phone: 830-879-2279