MEDICARE: PADRE ISLAND HEALTH SPECIALISTS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	K7201	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376657023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PADRE ISLAND HEALTH SPECIALISTS PA

Provider Business Mailing Address
First Line	:	3401 PADRE BLVD
Second Line	:	SUITE B
City	:	SOUTH PADRE ISLAND
State	:	TX
Zip	:	78597-7124
Country	:	US
Telephone Number	:	956-772-1911
Fax Number	:	956-772-9010

Provider Business Practice Location Address
First Line	:	3401 PADRE BLVD
Second Line	:	SUITE B
City	:	SOUTH PADRE ISLAND
State	:	TX
Zip	:	78597-7124
Country	:	US
Telephone Number	:	956-772-1911
Fax Number	:	956-772-9010

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROLANDO POSADA
Credential	:	MD
Telephone Number	:	956-772-1911

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	09/25/2008

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Directions to “PADRE ISLAND HEALTH SPECIALISTS PA ” Practice Location

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