Organization
DILYDIS INC
Active
Other names
CLINICA SAN FERNANDO
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NELSON LOGGIODICE PHYSICIAN ASSISTANT (PRESIDENT)
(956) 502-5513
Entity
Organization
Contact information
Practice address
3908 N. JACKSON RD, PHARR, TX 78577
(956) 502-5513
(956) 502-5514
Mailing address
3908 N JACKSON RD, PHARR, TX 78577-7768
(956) 502-5513
(956) 502-5514
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
PA03948
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217614101
—
TX
Enumeration date
06/01/2010
Last updated
10/02/2018
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