Provider Demographics
NPI:1043343437
Name:RGV PREVENTATIVE CARE INC
Entity Type:Organization
Organization Name:RGV PREVENTATIVE CARE INC
Other - Org Name:PREVENTATIVE CARE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:VICENTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAMBULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-971-0077
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78505-0278
Mailing Address - Country:US
Mailing Address - Phone:956-971-0077
Mailing Address - Fax:956-971-0076
Practice Address - Street 1:500 S BICENTENNIAL BLVD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5275
Practice Address - Country:US
Practice Address - Phone:956-971-0077
Practice Address - Fax:956-971-0076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00Y513Medicare PIN