MEDICARE: SOUTH TEXAS WOMEN'S HEALTH CENTER, P.A.

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	207V00000X	Obstetrics & Gynecology Physician	M4476	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	:	1538346085
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH TEXAS WOMEN'S HEALTH CENTER, P.A.

Provider Business Mailing Address
First Line	:	5419 SOUTH MCCOLL ROAD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-9183
Country	:	US
Telephone Number	:	956-630-0090
Fax Number	:	956-630-0099

Provider Business Practice Location Address
First Line	:	5419 SOUTH MCCOLL ROAD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-9183
Country	:	US
Telephone Number	:	956-630-0090
Fax Number	:	956-630-0099

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JUAN CARLOS CARLOS RIVERA
Credential	:	M.D.
Telephone Number	:	956-630-0090

Provider Enumeration Date	:	01/28/2008
Last Update Date	:	12/14/2010

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Directions to “SOUTH TEXAS WOMEN'S HEALTH CENTER, P.A. ” Practice Location

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