Provider Demographics
NPI:1114130218
Name:LOWER RIO GRANDE VALLEY COMMUNITY HEALTH MANAGEMENT CORPORATION INC
Entity Type:Organization
Organization Name:LOWER RIO GRANDE VALLEY COMMUNITY HEALTH MANAGEMENT CORPORATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARISOL
Authorized Official - Middle Name:
Authorized Official - Last Name:RESENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-213-6410
Mailing Address - Street 1:901 E VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1729
Mailing Address - Country:US
Mailing Address - Phone:956-213-6400
Mailing Address - Fax:956-213-0692
Practice Address - Street 1:901 E VERMONT AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1729
Practice Address - Country:US
Practice Address - Phone:956-213-6400
Practice Address - Fax:956-213-0692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080028601Medicaid
TXDC0619OtherRAILROAD MEDICARE
TX0015BROtherBCBS
TX0015BROtherBCBS