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Organization
PHARR PEDIATRIC CLINIC, PA
Active
Organization
PHARR PEDIATRIC CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISRAEL MATA M.D. (PHYSICIAN)
(956) 781-6591
Entity
Organization
Contact information
Practice address
105 E POLK AVE, PHARR, TX 78577-3110
(956) 781-6591
(956) 702-0185
Mailing address
105 E POLK AVE, PHARR, TX 78577-3110
(956) 781-6591
(956) 702-0185
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J2456
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178958801
—
TX
Enumeration date
10/19/2006
Last updated
06/22/2015
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