Organization
SUNRISE MEDICAL CLINIC PROFESSIONAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJEEV KUMAR MATHAVAN M.D. (CHAIRMAN)
(956) 310-2439
Entity
Organization
Contact information
Practice address
5017 S MCCOLL RD, EDINBURG, TX 78539-8080
(956) 627-2414
(956) 627-2076
Mailing address
PO BOX 2764, MCALLEN, TX 78502-2764
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
N0953
TX
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
N0953
TX
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
N0953
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0043TJ
BCBS
TX
05
—
208720701
—
TX
01
—
DR3128
RAILROAD MEDICARE
TX
Enumeration date
09/23/2009
Last updated
12/11/2018
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