Healthcare Provider Details

I. General information

NPI: 1801508684
Provider Name (Legal Business Name): RGV REGENERATIVE WOUND CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2022
Last Update Date: 12/23/2022
Certification Date: 12/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E NOLANA LOOP
PHARR TX
78577-9684
US

IV. Provider business mailing address

300 E NOLANA LOOP
PHARR TX
78577-9684
US

V. Phone/Fax

Practice location:
  • Phone: 956-715-8292
  • Fax: 956-715-8283
Mailing address:
  • Phone: 956-715-8292
  • Fax: 956-715-8283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FRANCISCO DEL BOSQUE
Title or Position: OWNER
Credential:
Phone: 956-715-8292