Healthcare Provider Details

I. General information

NPI: 1124312749
Provider Name (Legal Business Name): DARIA BABINEAUX MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2011
Last Update Date: 02/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4857 W HWY 83
ROMA TX
78584
US

IV. Provider business mailing address

214 CHAPARRAL BLVD
RIO GRANDE CITY TX
78582-0521
US

V. Phone/Fax

Practice location:
  • Phone: 956-849-0104
  • Fax: 956-849-3616
Mailing address:
  • Phone: 956-263-1830
  • Fax: 956-263-1836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL6771
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID A PEREZ
Title or Position: ASSISTANT ADMINISTRATOR/COUNSELOR
Credential:
Phone: 956-263-1830