Organization
PEDIATRIC PRACTICE ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CLAUDIA CERVANTES (COO)
(956) 488-1200
Entity
Organization
Contact information
Practice address
201 E 2ND ST, RIO GRANDE CITY, TX 78582-3803
(956) 488-1200
(956) 488-9500
Mailing address
201 E 2ND ST, RIO GRANDE CITY, TX 78582-3803
(956) 488-1200
(956) 488-9500
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
L4155
TX
Other
Enumeration date
08/25/2006
Last updated
08/06/2007
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