Healthcare Provider Details

I. General information

NPI: 1750006284
Provider Name (Legal Business Name): RGV INSTITUTE OF PAIN MANAGEMENT PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2022
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1506 S LONE STAR WAY STE 1
EDINBURG TX
78539-4977
US

IV. Provider business mailing address

1506 S LONE STAR WAY STE 1
EDINBURG TX
78539-4977
US

V. Phone/Fax

Practice location:
  • Phone: 956-731-0409
  • Fax: 956-322-4092
Mailing address:
  • Phone: 956-731-0409
  • Fax: 956-322-4092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDRES MAURICIO PEREZ
Title or Position: OWNER
Credential: MD
Phone: 956-731-0409