=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982733812
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RGV HARLINGEN FAMILY NIGHT CLINIC, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/05/2007
-----------------------------------------------------
Last Update Date | 07/17/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2226 HAINE DR
-----------------------------------------------------
City | HARLINGEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78550-8549
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-423-0085
-----------------------------------------------------
Fax | 956-412-3033
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2226 HAINE DR
-----------------------------------------------------
City | HARLINGEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78550-8549
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-423-1283
-----------------------------------------------------
Fax | 956-412-3033
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. DAVID SAUCEDA III
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 956-423-1283
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------