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General NPI Number Information
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NPI Number | 1477463073
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Entity Type | Organization
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Legal Business Name | RENAISSANCE MEDICAL FOUNDATION
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Dates
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Enumeration Date | 09/08/2026
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Last Update Date | 09/08/2026
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Provider Practice Location Address
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Address Line | 2816 DOCTORS DR STE B
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-2377
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Country | US
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Telephone | 956-362-9120
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 749
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City | PHARR
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State | TX
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Zip | 78577-1614
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Country | US
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Telephone | 956-362-2171
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Fax | 956-362-3614
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | ADA XOCHILTE GONZALEZ
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Credential |
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Telephone | 956-362-2171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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