Provider Demographics
NPI:1205019601
Name:CONRADO G. GALINDO III, MDPA
Entity Type:Organization
Organization Name:CONRADO G. GALINDO III, MDPA
Other - Org Name:CENIZA HILLS RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CONRADO
Authorized Official - Middle Name:G
Authorized Official - Last Name:GALINDO
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:830-775-0512
Mailing Address - Street 1:1300 N BEDELL AVE
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-7818
Mailing Address - Country:US
Mailing Address - Phone:830-775-0512
Mailing Address - Fax:830-775-1888
Practice Address - Street 1:1300 N BEDELL AVE
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-7818
Practice Address - Country:US
Practice Address - Phone:830-775-0512
Practice Address - Fax:830-775-1888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0189208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127293201Medicaid
TX127293201Medicaid
TXC15847Medicare UPIN
TX00U47MMedicare PIN