Healthcare Provider Details

I. General information

NPI: 1073714432
Provider Name (Legal Business Name): RODOLFO A QUINTANA PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 S 5TH ST STE 122
MCALLEN TX
78503-2915
US

IV. Provider business mailing address

PO BOX 5622
MCALLEN TX
78502-5622
US

V. Phone/Fax

Practice location:
  • Phone: 956-630-9454
  • Fax: 956-630-9447
Mailing address:
  • Phone: 956-630-9454
  • Fax: 956-630-9447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number32103
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: