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General NPI Number Information
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NPI Number | 1114964178
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Entity Type | Organization
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Legal Business Name | COLUMBIA RIO GRANDE HEALTHCARE, L.P.
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 101 E RIDGE RD
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City | MCALLEN
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State | TX
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Zip | 78503-1248
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Country | US
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Telephone | 956-632-6000
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Fax | 956-632-6621
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Provider Business Mailing Address
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Address Line | 101 E RIDGE RD
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City | MCALLEN
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State | TX
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Zip | 78503-1248
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Country | US
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Telephone | 956-632-6000
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Fax | 956-632-6621
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Authorized Official
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Title or Position | CFO
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Name | CHARLES MALLON
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Credential |
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Telephone | 956-632-6101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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