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1467633867

NPI Code Detail

MEDICARE: RENAISSANCE MEDICAL FOUNDATION

MEDICARE: RENAISSANCE MEDICAL FOUNDATION

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	2084P0804X	Child & Adolescent Psychiatry Physician
2	261QM1300X	Multi-Specialty Clinic/Center
3	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician
4	231H00000X	Audiologist
5	1041C0700X	Clinical Social Worker
6	2084P0800X	Psychiatry Physician
7	101YP2500X	Professional Counselor
8	207Q00000X	Family Medicine Physician
9	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
10	261Q00000X	Clinic/Center
11	363LF0000X	Family Nurse Practitioner
12	207RP1001X	Pulmonary Disease Physician
13	207Y00000X	Otolaryngology Physician
14	363A00000X	Physician Assistant
15	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1467633867
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENAISSANCE MEDICAL FOUNDATION

Provider Business Mailing Address
First Line	:	PO BOX 749
Second Line	:
City	:	PHARR
State	:	TX
Zip	:	78577-1614
Country	:	US
Telephone Number	:	956-362-2171
Fax Number	:	956-362-3614

Provider Business Practice Location Address
First Line	:	5501 S MCCOLL RD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-9152
Country	:	US
Telephone Number	:	956-362-3300
Fax Number	:	956-362-7684

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. ADA X GONZALEZ
Credential	:
Telephone Number	:	956-362-2171

Provider Enumeration Date	:	11/14/2007
Last Update Date	:	12/22/2025

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Directions to “RENAISSANCE MEDICAL FOUNDATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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