Provider Demographics
NPI:1134331028
Name:DIABETIC MANAGEMENT INSTITUTE OF SOUTH TEXAS, PLLC
Entity Type:Organization
Organization Name:DIABETIC MANAGEMENT INSTITUTE OF SOUTH TEXAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARCHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-793-6809
Mailing Address - Street 1:3009 WILLOWICKE ST
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550
Mailing Address - Country:US
Mailing Address - Phone:956-793-6809
Mailing Address - Fax:956-440-8791
Practice Address - Street 1:1810 HALE STREET
Practice Address - Street 2:SUITE 5
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550
Practice Address - Country:US
Practice Address - Phone:956-793-6809
Practice Address - Fax:956-440-8791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty