Healthcare Provider Details

I. General information

NPI: 1528010782
Provider Name (Legal Business Name): P I MEDICAL DAY & NIGHT CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 HIGHWAY 100 STE 5
PORT ISABEL TX
78578-2450
US

IV. Provider business mailing address

1200 HIGHWAY 100 STE 5
PORT ISABEL TX
78578-2462
US

V. Phone/Fax

Practice location:
  • Phone: 956-943-6675
  • Fax: 956-943-6864
Mailing address:
  • Phone: 956-943-6675
  • Fax: 956-943-6864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD GARZA
Title or Position: OWNER
Credential:
Phone: 956-943-6675