Healthcare Provider Details

I. General information

NPI: 1558931071
Provider Name (Legal Business Name): ANTONIO FALCON MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 06/28/2021
Certification Date: 06/28/2021
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 TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTONIO FALCON
Title or Position: OWNER
Credential: MD
Phone: 956-487-5621