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General NPI Number Information
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NPI Number | 1205851938
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Entity Type | Organization
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Legal Business Name | WESLACO MID VALLEY NIGHT CLINIC PA
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 1010 S AIRPORT DR
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City | WESLACO
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State | TX
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Zip | 78596-6600
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Country | US
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Telephone | 956-969-2609
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 713
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City | WESLACO
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State | TX
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Zip | 78599-0713
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Country | US
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Telephone | 956-969-2609
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. STEVE ALLEN PICHLER
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Credential | PA-C
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Telephone | 956-533-0660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | F7583
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License Number State | TX
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