Organization
SU CLINICA FAMILIAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADAM SALDIVAR (CFO)
(956) 365-6750
Entity
Organization
Contact information
Practice address
105 E ALTON GLOOR BLVD, BROWNSVILLE, TX 78526-3391
(956) 831-8338
(956) 831-3285
Mailing address
1706 TREASURE HILLS BLVD, HARLINGEN, TX 78550-8911
(956) 365-6750
(956) 365-6779
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019027401
—
TX
Enumeration date
07/28/2006
Last updated
11/19/2012
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