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General NPI Number Information
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NPI Number | 1720418098
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Entity Type | Individual
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Provider Name | EDGAR RICALDE LMSW
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Gender | Male
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Dates
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Enumeration Date | 11/22/2013
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Last Update Date | 11/22/2013
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Provider Practice Location Address
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Address Line | 521A TEAKWOOD LN
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City | LAREDO
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State | TX
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Zip | 78041-3751
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Country | US
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Telephone | 956-251-1455
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Fax | 210-568-6562
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Provider Business Mailing Address
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Address Line | PO BOX 2452
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City | LAREDO
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State | TX
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Zip | 78044-2452
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Country | US
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Telephone | 956-251-1455
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Fax | 210-568-6562
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 57805
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License Number State | TX
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