Provider Demographics
NPI:1407500580
Name:ARELLANO MEDICAL CLINIC LLC
Entity Type:Organization
Organization Name:ARELLANO MEDICAL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA
Authorized Official - Prefix:
Authorized Official - First Name:SALVADOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ARELLANO
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHYSICIAN ASSISTANT
Authorized Official - Phone:956-262-9661
Mailing Address - Street 1:3106 E INGLE RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-1402
Mailing Address - Country:US
Mailing Address - Phone:956-262-9661
Mailing Address - Fax:
Practice Address - Street 1:508 W EDINBURG AVE
Practice Address - Street 2:STE 105
Practice Address - City:ELSA
Practice Address - State:TX
Practice Address - Zip Code:78543-3008
Practice Address - Country:US
Practice Address - Phone:956-262-9661
Practice Address - Fax:956-262-9664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-08
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty