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General NPI Number Information
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NPI Number | 1205067964
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Entity Type | Organization
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Legal Business Name | RODOLFO A QUINTANA PSYD PA
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 09/30/2010
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Provider Practice Location Address
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Address Line | 1801 S 5TH ST STE 122
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City | MCALLEN
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State | TX
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Zip | 78503-2919
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Country | US
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Telephone | 956-630-9454
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Fax | 956-630-9447
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Provider Business Mailing Address
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Address Line | PO BOX 5622
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City | MCALLEN
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State | TX
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Zip | 78502-5622
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Country | US
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Telephone | 956-630-9454
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Fax | 956-630-9447
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Authorized Official
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Title or Position | OWNER
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Name | DR. RODOLFO A QUINTANA
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Credential | PSY.D.
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Telephone | 956-630-9454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 32103
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License Number State | TX
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