Organization
THE CLINIC AT THE PORT
Active
Other names
ALL VALLEY DRUG SCREENS
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAHOMA MAE PEDERSON (OWNER)
(956) 551-6742
Entity
Organization
Contact information
Practice address
3150 N. INDIANA AVE, BROWNSVILLE, TX 78526
(956) 831-3400
Mailing address
P.O. BOX 1822, LOS FRESNOS, TX 78566
(956) 831-3400
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/21/2012
Last updated
03/21/2012
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