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Organization
NORTHSIDE HEALTH CLINIC
Active
Organization
NORTHSIDE HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRMA E. MONTEMAYOR M.D. (MEDICAL DIRECTOR)
(830) 778-8442
Entity
Organization
Contact information
Practice address
106 FOSTER DR, DEL RIO, TX 78840-2757
(830) 778-8442
(830) 778-8321
Mailing address
106 FOSTER DR, DEL RIO, TX 78840-2757
(830) 778-8442
(830) 778-8321
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K4961
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0078DU
BLUE CROSS GROUP #
TX
Enumeration date
03/13/2007
Last updated
08/22/2020
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