Provider Demographics
NPI:1164028155
Name:RGV WOUND CARE HYPERBARICMEDICINE AND LYMPHEDEMA MANAGEMENT GROUP PLLC
Entity Type:Organization
Organization Name:RGV WOUND CARE HYPERBARICMEDICINE AND LYMPHEDEMA MANAGEMENT GROUP PLLC
Other - Org Name:RGV WOUND CARE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-287-1532
Mailing Address - Street 1:1200 E RIDGE RD STE 6
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1528
Mailing Address - Country:US
Mailing Address - Phone:956-331-8150
Mailing Address - Fax:956-331-8903
Practice Address - Street 1:1200 E RIDGE RD STE 6
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1528
Practice Address - Country:US
Practice Address - Phone:956-331-8150
Practice Address - Fax:956-331-8903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-07
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX420440601Medicaid