Healthcare Provider Details

I. General information

NPI: 1760088256
Provider Name (Legal Business Name): SU CLINICA FAMILIAR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2020
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1706 TREASURE HILLS BLVD
HARLINGEN TX
78550-8911
US

IV. Provider business mailing address

1706 TREASURE HILLS BLVD
HARLINGEN TX
78550-8911
US

V. Phone/Fax

Practice location:
  • Phone: 956-365-6000
  • Fax:
Mailing address:
  • Phone: 956-365-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSE A SALDIVAR
Title or Position: CFO
Credential: CFO
Phone: 956-365-6000