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General NPI Number Information
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NPI Number | 1356077143
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Entity Type | Organization
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Legal Business Name | ADIRA PHYSICIAN PARTNERS, PLLC
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Dates
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Enumeration Date | 07/25/2022
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 6999 MCPHERSON RD STE 108
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City | LAREDO
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State | TX
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Zip | 78041-6450
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Country | US
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Telephone | 860-335-6456
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Fax | 512-582-8585
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Provider Business Mailing Address
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Address Line | 10055 TULARE LN
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City | FORT WORTH
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State | TX
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Zip | 76177-7397
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Country | US
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Telephone | 817-913-5563
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. VICTOR BURGOS
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Credential | DO
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Telephone | 817-913-5563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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