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General NPI Number Information
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NPI Number | 1417138082
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Entity Type | Organization
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Legal Business Name | CELESTINO Z. AVILA, MD
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Dates
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Enumeration Date | 11/23/2007
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Last Update Date | 11/23/2007
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Provider Practice Location Address
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Address Line | 308 N SALINAS BLVD
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City | DONNA
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State | TX
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Zip | 78537-2930
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Country | US
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Telephone | 956-464-4497
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Fax |
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Provider Business Mailing Address
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Address Line | 308 N SALINAS BLVD
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City | DONNA
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State | TX
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Zip | 78537-2930
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | CARMEL CARRILLO
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Credential |
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Telephone | 956-973-9009
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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 | F1352
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License Number State | TX
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