Organization
RENAISSANCE MEDICAL FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADA X GONZALEZ (ADMINISTRATOR)
(956) 362-2171
Entity
Organization
Contact information
Practice address
5502 S MCCOLL RD, EDINBURG, TX 78539-8747
(956) 362-2171
(956) 362-2132
Mailing address
5502 S MCCOLL RD, EDINBURG, TX 78539-8747
(956) 362-2171
(956) 362-2132
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
781566
TX
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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