Healthcare Provider Details

I. General information

NPI: 1205378700
Provider Name (Legal Business Name): RGV CLINIC FOR YOU, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2016
Last Update Date: 11/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E NOLANA LOOP
PHARR TX
78577-9684
US

IV. Provider business mailing address

3226 W ALBERTA RD
EDINBURG TX
78539-9635
US

V. Phone/Fax

Practice location:
  • Phone: 956-781-8464
  • Fax: 956-781-8471
Mailing address:
  • Phone: 956-781-8471
  • Fax: 956-781-8471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberJ6969
License Number StateTX

VIII. Authorized Official

Name: MRS. MARY J MCCOY
Title or Position: ADMINISTRATOR
Credential: FNP-C
Phone: 956-781-8464