Healthcare Provider Details
I. General information
NPI: 1043343437
Provider Name (Legal Business Name): RGV PREVENTATIVE CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2007
Last Update Date: 02/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 S BICENTENNIAL BLVD
MCALLEN TX
78501-5275
US
IV. Provider business mailing address
PO BOX 278
MCALLEN TX
78505-0278
US
V. Phone/Fax
- Phone: 956-971-0077
- Fax: 956-971-0076
- Phone: 956-971-0077
- Fax: 956-971-0076
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207UN0901X |
| Taxonomy | Nuclear Cardiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
VICENTE
ARAMBULA
Title or Position: COO
Credential:
Phone: 956-971-0077