Organization
THE EAGLE FORD CLINICS, PA
Active
Other names
Hood Medical Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
SURESH V DUTTA JR. MD (MD/OWNER)
(830) 965-1684
Entity
Organization
Contact information
Practice address
111 E. MILLER ST., DILLEY, TX 78017
(830) 965-1684
(830) 965-1278
Mailing address
111 E. MILLER ST., DILLEY, TX 78017
(830) 965-1684
(830) 965-1278
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0057PD
BCBS GRP NUMBER
TX
01
—
00X375
MEDICARE GROUP
TX
05
—
187810001
—
TX
Enumeration date
03/28/2007
Last updated
03/16/2016
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