Healthcare Provider Details

I. General information

NPI: 1417985573
Provider Name (Legal Business Name): ROBERTO J. VIETO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 04/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S RANGERVILLE RD BLDG. 503
HARLINGEN TX
78552-7638
US

IV. Provider business mailing address

1401 S RANGERVILLE RD BLDG. 503
HARLINGEN TX
78552-7638
US

V. Phone/Fax

Practice location:
  • Phone: 956-364-8412
  • Fax: 956-364-8497
Mailing address:
  • Phone: 956-364-8412
  • Fax: 956-364-8497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG2502
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: