Healthcare Provider Details
I. General information
NPI: 1679683890
Provider Name (Legal Business Name): SOUTH TEXAS PRIMARY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
220 W HILLSIDE RD STE 8
LAREDO TX
78041-6903
US
IV. Provider business mailing address
220 W HILLSIDE RD STE 8
LAREDO TX
78041-6903
US
V. Phone/Fax
- Phone: 956-725-3804
- Fax: 956-725-0182
- Phone: 956-725-3804
- Fax: 956-725-0182
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 006398 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ALFONSO
RODRIGUEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 956-725-3804