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General NPI Number Information
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NPI Number | 1356164008
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Entity Type | Organization
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Legal Business Name | DAVILA'S CLINIC, PLLC
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 412 E 18TH ST STE E
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City | WESLACO
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State | TX
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Zip | 78596-8032
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Country | US
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Telephone | 956-520-7050
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Fax | 956-520-7001
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Provider Business Mailing Address
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Address Line | 412 E 18TH ST STE E
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City | WESLACO
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State | TX
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Zip | 78596-8032
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Country | US
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Telephone | 956-520-7050
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Fax | 956-517-1366
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | JUSTIN DAVILA
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Credential | NP
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Telephone | 956-520-7050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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