Organization
SU CLINICA FAMILIAR
Active
Other names
SU CLINICA FAMILIAR
Organization subpart
No
Provider details
NPI number
Authorized official
ELENA MARIN MD (EXECUTIVE DIRECTOR)
(956) 365-6750
Entity
Organization
Contact information
Practice address
131 FM 3168, RAYMONDVILLE, TX 78580-3605
(956) 689-5216
(956) 689-5937
Mailing address
1706 TREASURE HILLS BLVD, HARLINGEN, TX 78550-8911
(956) 365-6005
(956) 365-6770
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
A01094
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2099012
PK
—
Enumeration date
09/14/2006
Last updated
09/28/2016
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