Healthcare Provider Details

I. General information

NPI: 1750304846
Provider Name (Legal Business Name): FAMILY HEALTH CENTER LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
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 Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateTX

VIII. Authorized Official

Name: AIDA SOZA
Title or Position: ADMINISTRATOR
Credential: CRHCP, CMOM, CMC
Phone: 956-487-5621