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General NPI Number Information
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NPI Number | 1619032505
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Entity Type | Organization
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Legal Business Name | UNITED RENAL CARE L.L.C.
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1217 PECAN BLVD
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City | MCALLEN
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State | TX
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Zip | 78501-4349
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Country | US
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Telephone | 956-682-5578
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Fax | 956-682-4653
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Provider Business Mailing Address
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Address Line | 1217 PECAN BLVD
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City | MCALLEN
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State | TX
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Zip | 78501-4349
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Country | US
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Telephone | 956-682-5578
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Fax | 956-682-4653
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CARLOS BENJAMIN CARRALES
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Credential | REGISTERED NURSE
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Telephone | 956-682-5578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 581780
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License Number State | TX
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