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General NPI Number Information
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NPI Number | 1457302085
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Entity Type | Organization
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Legal Business Name | LA FERIA MEDICAL CLINIC, P.A.
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 09/24/2008
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Provider Practice Location Address
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Address Line | 129 W COMMERCIAL AVE
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City | LA FERIA
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State | TX
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Zip | 78559-5108
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Country | US
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Telephone | 956-797-9200
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Fax | 956-797-1018
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Provider Business Mailing Address
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Address Line | 129 W COMMERCIAL AVE
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City | LA FERIA
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State | TX
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Zip | 78559-5108
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Country | US
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Telephone | 956-797-9200
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Fax | 956-797-1018
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Authorized Official
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Title or Position | MANAGER
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Name | MR. JAVIER VAZQUEZ
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Credential |
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Telephone | 956-428-3701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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