Provider Demographics
NPI:1285865683
Name:SAINT JOSEPH MEDICAL CENTER, S.A. DE C.V.
Entity Type:Organization
Organization Name:SAINT JOSEPH MEDICAL CENTER, S.A. DE C.V.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:XOCHITL
Authorized Official - Middle Name:P
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-943-4673
Mailing Address - Street 1:807 VETERANS BLVD APT B
Mailing Address - Street 2:#181
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-4041
Mailing Address - Country:US
Mailing Address - Phone:830-734-7034
Mailing Address - Fax:
Practice Address - Street 1:775 MADERO ZONA CENTRO
Practice Address - Street 2:
Practice Address - City:ACUNA
Practice Address - State:COAUHILA
Practice Address - Zip Code:26200
Practice Address - Country:MX
Practice Address - Phone:877-943-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty