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General NPI Number Information
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NPI Number | 1811436504
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF TEXAS RIO GRANDE VALLEY
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 03/15/2023
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Provider Practice Location Address
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Address Line | 3341 E RICHARDSON RD
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City | EDINBURG
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State | TX
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Zip | 78542-0353
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Country | US
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Telephone | 956-318-2915
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Fax |
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Provider Business Mailing Address
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Address Line | 2102 TREASURE HILLS BLVD # 3.144
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City | HARLINGEN
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State | TX
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Zip | 78550-8736
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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 | FOUNDING PRESIDENT
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Name | GUY BAILEY
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Credential | PHD
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Telephone | 956-296-1418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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