Organization
COMPASS VISTA SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE CANDELARIO (ADMINISTRATION)
(512) 535-0322
Entity
Organization
Contact information
Practice address
5501 S EXPRESSWAY 77, HARLINGEN, TX 78550-3213
(956) 365-1167
(956) 365-1073
Mailing address
611 STAPLES RD, SAN MARCOS, TX 78666-1426
(512) 535-0322
(866) 361-1103
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0095RH
BCBS-MD
TX
01
—
00C547
BCBS
TX
05
—
197603701
—
TX
Enumeration date
03/27/2008
Last updated
04/14/2011
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