# SOUTH LAREDO FAMILY CLINIC PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578571451
- **Authorized official:** MATEO REYES MD (MD)
- **Authorized official phone:** (956) 722-5007

## Contact information

- **Practice address:** 3527 JAIME ZAPATA MEMORIAL HWY, SUITE 101, LAREDO, TX 78043-4788
- **Practice address phone:** (956) 722-5007
- **Practice address fax:** (956) 725-5894
- **Mailing address:** PO BOX 451490, LAREDO, TX 78045
- **Mailing address phone:** (956) 722-5007
- **Mailing address fax:** (956) 725-5894

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/04/2006
- **Last updated:** 10/08/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 193927401 | — | TX |