Healthcare Provider Details
I. General information
NPI: 1003977943
Provider Name (Legal Business Name): COMMUNITY ACTION COUNCIL OF SOUTH TEXAS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
683 N CANALES CIR
ROMA TX
78584-8053
US
IV. Provider business mailing address
PO BOX 98
RIO GRANDE CITY TX
78582-0098
US
V. Phone/Fax
- Phone: 956-847-2312
- Fax: 956-849-0143
- Phone: 956-487-2585
- Fax: 956-487-6670
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 173000000X |
| Taxonomy | Legal Medicine |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
FRANCISCO
G
ZARATE
Title or Position: EXEXUTIVE DIRECTOR
Credential:
Phone: 956-487-2585