Organization
CLINICA DE PUEBLO DE PALMAS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEE TREVINO RN (OFFICE MANAGER)
(956) 792-5606
Entity
Organization
Contact information
Practice address
3204 MILE 5 RD, MISSION, TX 78574-6206
(956) 424-9863
(956) 424-9868
Mailing address
3204 MILE 5 RD, MISSION, TX 78574-6206
(956) 424-9863
(956) 424-9868
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
801379109
INCORPORATION NUMBER
TX
Enumeration date
02/11/2011
Last updated
08/29/2011
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