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Organization
MI VIDA PRIMARY CARE LLC
Active
Organization
MI VIDA PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN L PENA (PARTNER)
(956) 789-5515
Entity
Organization
Contact information
Practice address
3318 N 21ST ST, MCALLEN, TX 78501-6062
(956) 789-5515
(361) 396-1283
Mailing address
3318 N 21ST ST, MCALLEN, TX 78501-6062
(956) 789-5515
(361) 396-1283
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
AP126924
TX
363LC1500X
Community Health Nurse Practitioner
AP126924
TX
363LF0000X
Family Nurse Practitioner
Primary
AP126924
TX
363LP2300X
Primary Care Nurse Practitioner
AP126924
TX
Other
Enumeration date
06/10/2015
Last updated
06/10/2015
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