Healthcare Provider Details

I. General information

NPI: 1427295948
Provider Name (Legal Business Name): PEDIATRIC HEART CLINIC OF MCALLEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2009
Last Update Date: 03/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5506 S JACKSON RD
EDINBURG TX
78539-9902
US

IV. Provider business mailing address

5506 S JACKSON RD
EDINBURG TX
78539-9902
US

V. Phone/Fax

Practice location:
  • Phone: 956-661-0066
  • Fax: 956-661-0071
Mailing address:
  • Phone: 956-661-0066
  • Fax: 956-661-0071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ASSAD I ALHROOB
Title or Position: OWNER
Credential: MD
Phone: 956-661-0066