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General NPI Number Information
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NPI Number | 1255604179
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Entity Type | Organization
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Legal Business Name | PEDIATRIC ASSOCIATES AT RIDGE
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Dates
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Enumeration Date | 02/23/2012
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 1200 E RIDGE RD STE 12
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City | MCALLEN
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State | TX
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Zip | 78503-1528
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Country | US
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Telephone | 956-631-5333
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Fax | 877-409-1929
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Provider Business Mailing Address
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Address Line | 1200 E RIDGE RD STE 12
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City | MCALLEN
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State | TX
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Zip | 78503-1528
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Country | US
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Telephone | 956-631-5333
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Fax | 956-631-5803
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. IRMA ROBLEDO
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Credential |
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Telephone | 956-631-5333
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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 | L2067
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License Number State | TX
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