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Organization

RIO BRAVO CANCER & BLOOD, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DIEGO TAYLOR (ADMINISTRATOR)
(830) 775-5800
Entity
Organization

Contact information

Practice address
1301 AVENUE G, DEL RIO, TX 78840-3627
(830) 775-5800
Mailing address
PO BOX 1315, DEL RIO, TX 78841-1315
(830) 775-8000

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00522W
MEDICARE
TX
05
1651671 (01)
TX
01
49LW
BC/BS GROUP NUMBER
TX
01
DC5372
RAILROAD MEDICARE GROUP #
TX
Enumeration date
08/01/2006
Last updated
03/10/2023
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