Healthcare Provider Details

I. General information

NPI: 1417338286
Provider Name (Legal Business Name): ALCIDES AMADOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2015
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2902 HAINE DR
HARLINGEN TX
78550-8969
US

IV. Provider business mailing address

PO BOX 531968
HARLINGEN TX
78553-1968
US

V. Phone/Fax

Practice location:
  • Phone: 956-296-3821
  • Fax: 956-296-3820
Mailing address:
  • Phone: 833-887-4863
  • Fax: 956-296-6842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberR0684
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: