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General NPI Number Information
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NPI Number | 1306012281
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Entity Type | Organization
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Legal Business Name | PEDIATRIC HOSPITAL CARE OF HARLINGEN
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Dates
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Enumeration Date | 05/01/2008
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Last Update Date | 10/14/2011
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Provider Practice Location Address
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Address Line | 5111 N 10TH ST 281
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City | MCALLEN
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State | TX
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Zip | 78504-2835
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Country | US
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Telephone | 877-543-7247
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Fax | 956-994-0114
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Provider Business Mailing Address
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Address Line | 5111 N 10TH ST 281
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City | MCALLEN
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State | TX
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Zip | 78504-2835
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Country | US
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Telephone | 877-543-7247
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Fax | 956-994-0114
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Authorized Official
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Title or Position | CEO
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Name | DR. OTTO R VELASQUEZ
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Credential | M.D.
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Telephone | 877-543-7247
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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 |
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License Number State | TX
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