Healthcare Provider Details

I. General information

NPI: 1750692885
Provider Name (Legal Business Name): EDINBURG OBSTETRICS GYNECOLOGY & INFERTILITY CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 06/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 N 23RD ST STE 1
MCALLEN TX
78501-6179
US

IV. Provider business mailing address

3001 N 23RD ST STE 1
MCALLEN TX
78501-6179
US

V. Phone/Fax

Practice location:
  • Phone: 956-661-0044
  • Fax: 956-994-0745
Mailing address:
  • Phone: 956-661-0044
  • Fax: 956-994-0745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ADA XOCHILTE GONZALEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 956-380-3441