MEDICARE: RURAL CLINICS OF SOUTH TEXAS, LLC

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	261QR1300X	Rural Health Clinic/Center	E2903	TX

General Provider Information

NPI Number	:	1962536573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RURAL CLINICS OF SOUTH TEXAS, LLC

Provider Business Mailing Address
First Line	:	202 2ND ST
Second Line	:
City	:	PORT ISABEL
State	:	TX
Zip	:	78578-4100
Country	:	US
Telephone Number	:	956-943-1774
Fax Number	:	956-943-7938

Provider Business Practice Location Address
First Line	:	202 2ND ST
Second Line	:
City	:	PORT ISABEL
State	:	TX
Zip	:	78578-4100
Country	:	US
Telephone Number	:	956-943-1774
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WILLIAM H TORKILDSEN
Credential	:	M.D
Telephone Number	:	956-943-1774

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	06/12/2024

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