# SU CLINICA FAMILIAR

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SU CLINICA FAMILIAR
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194820969
- **Authorized official:** ELENA MARIN MD (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (956) 365-6750

## Contact information

- **Practice address:** 131 FM 3168, RAYMONDVILLE, TX 78580-3605
- **Practice address phone:** (956) 689-5216
- **Practice address fax:** (956) 689-5937
- **Mailing address:** 1706 TREASURE HILLS BLVD, HARLINGEN, TX 78550-8911
- **Mailing address phone:** (956) 365-6005
- **Mailing address fax:** (956) 365-6770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | A01094 | TX | Yes |

## Other

- **Enumeration date:** 09/14/2006
- **Last updated:** 09/28/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2099012 | PK | — |