Organization
RIO GRANDE STATE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID MORON MD (CLINICAL DIRECTOR)
(956) 364-8375
Entity
Organization
Contact information
Practice address
1401 S RANGERVILLE RD, HARLINGEN, TX 78552-7638
(956) 364-8375
Mailing address
1401 S RANGERVILLE RD, HARLINGEN, TX 78552-7638
(956) 364-8375
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
DT82349
TX
Other
Enumeration date
08/06/2012
Last updated
08/06/2012
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