Organization
RIO BRAVO CANCER & BLOOD, P.A.
Active
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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