Healthcare Provider Details
I. General information
NPI: 1568302586
Provider Name (Legal Business Name): COLUMBIA RIO GRANDE HEALTHCARE, L.P.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
102 W GRIFFIN PKWY
MISSION TX
78572-2336
US
IV. Provider business mailing address
102 W GRIFFIN PKWY
MISSION TX
78572-2336
US
V. Phone/Fax
- Phone: 956-445-1600
- Fax:
- Phone: 956-445-1600
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QE0002X |
| Taxonomy | Emergency Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LAURA
DISQUE
Title or Position: CEO
Credential:
Phone: 956-632-6100