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General NPI Number Information
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NPI Number | 1912733817
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Entity Type | Organization
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Legal Business Name | UNITED MEDICAL CENTERS
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 3809 VETERANS BLVD
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City | DEL RIO
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State | TX
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Zip | 78840-2860
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Country | US
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Telephone | 830-488-6961
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Fax | 866-714-1737
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Provider Business Mailing Address
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Address Line | PO BOX 1470
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City | EAGLE PASS
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State | TX
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Zip | 78853-1470
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Country | US
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Telephone | 830-773-8917
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | RAFAEL E OLVERA
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Credential | MBA
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Telephone | 830-773-8917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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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 | 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 #3
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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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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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