Healthcare Provider Details

I. General information

NPI: 1871350413
Provider Name (Legal Business Name): RGV VASCULAR & VEIN AT EDINBURG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2024
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1621 S CLOSNER BLVD
EDINBURG TX
78539-6319
US

IV. Provider business mailing address

1317 ST CLAIRE BLVD STE A5
MISSION TX
78572-6636
US

V. Phone/Fax

Practice location:
  • Phone: 956-997-6000
  • Fax: 956-997-0614
Mailing address:
  • Phone: 956-997-6000
  • Fax: 956-997-0614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DALIA COBOS
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 956-997-6000