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General NPI Number Information
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NPI Number | 1366840043
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Entity Type | Organization
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Legal Business Name | AFFORDABLE CARE CLINIC PLLC
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Dates
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Enumeration Date | 12/12/2014
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Last Update Date | 09/12/2016
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Provider Practice Location Address
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Address Line | 2300 CENTRAL BLVD
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City | BROWNSVILLE
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State | TX
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Zip | 78520-8714
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Country | US
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Telephone | 956-544-5312
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Fax |
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Provider Business Mailing Address
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Address Line | 1165 SYCAMORE DR
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City | BROWNSVILLE
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State | TX
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Zip | 78520-8324
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Country | US
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Telephone | 956-466-1931
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Fax | 956-517-1477
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Authorized Official
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Title or Position | OWENER
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Name | PAUL LENZ
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Credential |
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Telephone | 956-466-1931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | J7553
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License Number State | TX
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