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Organization
PEDIATRIC PRACTICE ASSOCIATION
Active
Organization
PEDIATRIC PRACTICE ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA GONZALEZ (CHIEF OPERATIONS OFFICER)
(956) 488-1200
Entity
Organization
Contact information
Practice address
5322 E HWY 83 STE C4, RIO GRANDE CITY, TX 78582-9461
(956) 488-0330
Mailing address
201 E 2ND ST, RIO GRANDE CITY, TX 78582-3803
(956) 488-1200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04749
TX
Other
Enumeration date
12/05/2008
Last updated
12/05/2008
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