Healthcare Provider Details
I. General information
NPI: 1023439163
Provider Name (Legal Business Name): RGV PATHOLOGY CONSULTANTS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/16/2013
Last Update Date: 10/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
612 W NOLANA AVE STE 330 ATTN: ENRIQUE MENENDEZ
MCALLEN TX
78504-3088
US
IV. Provider business mailing address
612 W NOLANA AVE STE 330 SUITE 330
MCALLEN TX
78504-3088
US
V. Phone/Fax
- Phone: 956-630-2225
- Fax: 956-630-2275
- Phone: 956-630-2225
- Fax: 956-630-2275
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | P1259 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
RUDY
ALVAREZ
Title or Position: CEO
Credential: M.D.
Phone: 956-630-2225