Organization
ST. MARIE CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDUARDO CARRILLO M.D. (CEO)
(956) 585-7401
Entity
Organization
Contact information
Practice address
305 E EXPRESSWAY 83, MISSION, TX 78572-5560
(956) 583-3775
(956) 583-5833
Mailing address
305 E EXPRESSWAY 83, MISSION, TX 78572-5560
(956) 585-7401
(956) 583-5833
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168788104
—
TX
Enumeration date
07/24/2006
Last updated
08/14/2008
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