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General NPI Number Information
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NPI Number | 1619291150
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Entity Type | Organization
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Legal Business Name | RGV SURGICAL ASSISTING, INC.
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Dates
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Enumeration Date | 03/25/2010
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Last Update Date | 03/25/2010
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Provider Practice Location Address
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Address Line | 1402 E 6TH ST
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City | WESLACO
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State | TX
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Zip | 78596-6603
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Country | US
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Telephone | 956-968-6155
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 256
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City | WESLACO
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State | TX
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Zip | 78599-0256
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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 | PRESIDENT
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Name | RICARDO CONTRERAS
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Credential | CFA, LSA
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Telephone | 956-650-9769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | SA00333
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License Number State | TX
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