Organization
MI VIDA PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN PENA (MANAGING MEMBER)
(956) 624-9312
Entity
Organization
Contact information
Practice address
3318 N 21ST ST, MCALLEN, TX 78501-6062
(956) 789-5515
(361) 396-1283
Mailing address
3318 N 21ST ST, MCALLEN, TX 78501-6062
(956) 789-5515
(361) 396-1283
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
AP126924
TX
Other
Enumeration date
12/22/2014
Last updated
12/22/2014
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