Healthcare Provider Details

I. General information

NPI: 1295033058
Provider Name (Legal Business Name): RGVO 20 MIN CLINIC,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 03/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 E NOLANA LOOP
MCALLEN TX
78504-6101
US

IV. Provider business mailing address

1005 E NOLANA LOOP
MCALLEN TX
78504-6101
US

V. Phone/Fax

Practice location:
  • Phone: 956-686-6510
  • Fax: 956-688-6674
Mailing address:
  • Phone: 956-686-6510
  • Fax: 956-688-6674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GUILLERMO R PECHERO
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 956-686-6510