Healthcare Provider Details

I. General information

NPI: 1831256205
Provider Name (Legal Business Name): RIO GRANDE SURGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 01/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5513 DOCTORS DRIVE
EDINBURG TX
78539
US

IV. Provider business mailing address

P.O. BOX 720428
MCALLEN TX
78504
US

V. Phone/Fax

Practice location:
  • Phone: 956-994-1025
  • Fax: 956-994-3930
Mailing address:
  • Phone: 956-994-1025
  • Fax: 956-994-3930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: NORMA MALTOS
Title or Position: OFFICE MANAGER
Credential:
Phone: 956-994-1025