Healthcare Provider Details

I. General information

NPI: 1619082435
Provider Name (Legal Business Name): MCALLEN PEDIATRIC CLINIC, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 S 5TH ST SUITE 114
MCALLEN TX
78503-2927
US

IV. Provider business mailing address

1801 S 5TH ST SUITE 114
MCALLEN TX
78503-2927
US

V. Phone/Fax

Practice location:
  • Phone: 956-682-6346
  • Fax: 956-618-1199
Mailing address:
  • Phone: 956-682-6346
  • Fax: 956-618-1199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID ROSTENBERG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 956-682-6346