Healthcare Provider Details

I. General information

NPI: 1164526745
Provider Name (Legal Business Name): MEDICAL & TRAUMA SPECIALISTS, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805 FOUNTAIN PLAZA BLVD STE A
EDINBURG TX
78539-8031
US

IV. Provider business mailing address

PO BOX 4582
MCALLEN TX
78502-4582
US

V. Phone/Fax

Practice location:
  • Phone: 956-668-9800
  • Fax: 956-668-8438
Mailing address:
  • Phone: 956-668-9880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number300221
License Number StateTX

VIII. Authorized Official

Name: DANIEL A DIAZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 956-668-9880