Provider Demographics
NPI:1225652779
Name:RGV URGENT CARE CLINIC MCALLEN LLC
Entity Type:Organization
Organization Name:RGV URGENT CARE CLINIC MCALLEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:I
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-803-0120
Mailing Address - Street 1:3502 W ALBERTA RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-8466
Mailing Address - Country:US
Mailing Address - Phone:956-803-0120
Mailing Address - Fax:956-803-0123
Practice Address - Street 1:2812 W NOLANA AVE STE 210
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4190
Practice Address - Country:US
Practice Address - Phone:956-803-0120
Practice Address - Fax:956-803-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0303828-08Medicaid