Healthcare Provider Details

I. General information

NPI: 1477849107
Provider Name (Legal Business Name): RGV ALLIED HEALTH GROUP, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 06/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 ANGELITA DR STE 7
WESLACO TX
78596-4790
US

IV. Provider business mailing address

505 ANGELITA DR STE 7
WESLACO TX
78596-4790
US

V. Phone/Fax

Practice location:
  • Phone: 956-968-0585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: ORLANDO VELAZQUEZ
Title or Position: OWNER
Credential:
Phone: 956-245-3390