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General NPI Number Information
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NPI Number | 1982887733
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Entity Type | Organization
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Legal Business Name | ALICE HEALTH MEDICAL CLINIC
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Dates
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Enumeration Date | 12/14/2007
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Last Update Date | 12/14/2007
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Provider Practice Location Address
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Address Line | 2510 E MAIN ST STE. 108
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City | ALICE
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State | TX
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Zip | 78332-4187
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Country | US
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Telephone | 361-664-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 2510 E MAIN ST SUITE 108
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City | ALICE
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State | TX
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Zip | 78332-4187
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Country | US
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Telephone | 361-664-9300
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CELSA AGUILAR
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Credential |
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Telephone | 361-664-8530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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