Organization
ISLAND MEDICAL COLLEGE STATION, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN DE LA PRIDA (CFO)
(631) 514-7600
Entity
Organization
Contact information
Practice address
1604 ROCK PRAIRIE RD, COLLEGE STATION, TX 77845-8345
(979) 764-5101
Mailing address
PO BOX 92990, CLEVELAND, OH 44194-2990
(330) 656-5911
(330) 656-5901
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
09/15/2017
Last updated
09/15/2017
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