Healthcare Provider Details

I. General information

NPI: 1386895225
Provider Name (Legal Business Name): RGV PREVENTATIVE CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2008
Last Update Date: 10/10/2008
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

500 S BICENTENNIAL BLVD
MCALLEN TX
78501-5275
US

V. Phone/Fax

Practice location:
  • Phone: 956-971-0077
  • Fax: 956-971-0076
Mailing address:
  • Phone: 956-971-0077
  • Fax: 956-971-0076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberR31044
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License NumberR31044
License Number StateTX

VIII. Authorized Official

Name: VICENTE ARAMBULA
Title or Position: CEO
Credential:
Phone: 956-971-0077