Healthcare Provider Details

I. General information

NPI: 1144480815
Provider Name (Legal Business Name): JAMES ANTONIO FALCON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2768 PHARMACY RD
RIO GRANDE CITY TX
78582-6201
US

IV. Provider business mailing address

2768 PHARMACY RD
RIO GRANDE CITY TX
78582-6201
US

V. Phone/Fax

Practice location:
  • Phone: 956-487-5621
  • Fax: 956-487-5862
Mailing address:
  • Phone: 956-487-5621
  • Fax: 956-487-5862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2015-01575
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number25380
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberS8437
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: