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General NPI Number Information
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NPI Number | 1134331028
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Entity Type | Organization
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Legal Business Name | DIABETIC MANAGEMENT INSTITUTE OF SOUTH TEXAS, PLLC
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1810 HALE STREET SUITE 5
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City | HARLINGEN
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State | TX
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Zip | 78550
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Country | US
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Telephone | 956-793-6809
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Fax | 956-440-8791
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Provider Business Mailing Address
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Address Line | 3009 WILLOWICKE ST
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City | HARLINGEN
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State | TX
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Zip | 78550
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Country | US
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Telephone | 956-793-6809
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Fax | 956-440-8791
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CARLOS A ARCHE
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Credential | M.D.
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Telephone | 956-793-6809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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