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General NPI Number Information
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NPI Number | 1326029844
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Entity Type | Organization
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Legal Business Name | THE EAGLE FORD CLINICS, PA
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 10/29/2014
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Provider Practice Location Address
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Address Line | 207 TILDEN
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City | COTULLA
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State | TX
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Zip | 78014-2161
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Country | US
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Telephone | 830-879-2358
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Fax | 830-879-3107
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Provider Business Mailing Address
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Address Line | 207 TILDEN
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City | COTULLA
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State | TX
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Zip | 78014-2161
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Country | US
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Telephone | 830-879-2358
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Fax | 830-879-3107
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Authorized Official
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Title or Position | OWNER
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Name | SURESH V DUTTA
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Credential | MD
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Telephone | 830-965-1684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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