Organization
PHYSICIAN CARE & DIAGNOSTICS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODOLFO MALDONADO (MEMBER)
(832) 692-6560
Entity
Organization
Contact information
Practice address
3829 SARATOGA BLVD, CORPUS CHRISTI, TX 78415-5814
(361) 225-2624
Mailing address
PO BOX 420719, HOUSTON, TX 77242-0719
Taxonomy
Speciality
Code
Description
License number
State
246XS1301X
Sonography Specialist/Technologist Cardiovascular
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0330DC
BC/BS OF TEXAS
TX
05
—
160385401
—
TX
Enumeration date
12/21/2005
Last updated
02/11/2014
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