MEDICARE: UNIVERSITY OF TEXAS RIO GRANDE VALLEY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103TC0700X	Clinical Psychologist
2	152W00000X	Optometrist
3	207Q00000X	Family Medicine Physician
4	207QS0010X	Sports Medicine (Family Medicine) Physician
5	101YP2500X	Professional Counselor
6	207V00000X	Obstetrics & Gynecology Physician
7	208000000X	Pediatrics Physician
8	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician
9	2084P0800X	Psychiatry Physician
10	208600000X	Surgery Physician
11	2086S0102X	Surgical Critical Care Physician
12	2086S0122X	Plastic and Reconstructive Surgery Physician
13	261QA0005X	Ambulatory Family Planning Facility
14	291U00000X	Clinical Medical Laboratory
15	207R00000X	Internal Medicine Physician

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	:	1477960730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY OF TEXAS RIO GRANDE VALLEY

Provider Business Mailing Address
First Line	:	PO BOX 531968
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78553-1968
Country	:	US
Telephone Number	:	956-296-1437
Fax Number	:	956-296-6842

Provider Business Practice Location Address
First Line	:	2102 TREASURE HILLS BLVD
Second Line	:	314406
City	:	HARLINGEN
State	:	TX
Zip	:	78550-8736
Country	:	US
Telephone Number	:	956-296-1437
Fax Number	:	956-296-6842

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	JESSICA GRAHAM
Credential	:
Telephone Number	:	956-296-1437

Provider Enumeration Date	:	07/18/2014
Last Update Date	:	07/11/2025

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Directions to “UNIVERSITY OF TEXAS RIO GRANDE VALLEY ” Practice Location

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