Organization
COLUMBIA RIO GRANDE HEALTHCARE,L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES MALLON (CFO)
(956) 632-6101
Entity
Organization
Contact information
Practice address
427 E DURANTA AVE STE 108, ALAMO, TX 78516-3409
(956) 787-0770
Mailing address
222 E RIDGE RD STE 101, MCALLEN, TX 78503-1251
(956) 632-6032
(956) 971-9539
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
518243
TX
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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