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Organization
RODERICK V. VERGEL DE DIOS, M.D., P.A.
Active
Organization
RODERICK V. VERGEL DE DIOS, M.D., P.A.
Active
Other names
Vergel de Dios Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODERICK VILLAROMAN VERGEL DE DIOS M.D. (DIRECTOR)
(956) 686-6644
Entity
Organization
Contact information
Practice address
5105 N MCCOLL RD, MCALLEN, TX 78504-2331
(956) 686-6644
(956) 686-6643
Mailing address
5105 N MCCOLL RD, MCALLEN, TX 78504-2331
(956) 686-6644
(956) 686-6643
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K1713
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021DF
BLUE CROSS BLUE SHIELD
TX
01
—
080152499
RAILROAD MEDICARE
—
01
—
116761
SUPERIOR HEALTH PLAN
—
05
—
126632202
—
TX
01
—
126632205
MEDICAID EPSDT
TX
01
—
5805616
AETNA
—
01
—
A001
CHAMPUS
—
01
—
A002
TRICARE
—
Enumeration date
07/18/2008
Last updated
10/26/2010
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