Provider Demographics
NPI:1417729179
Name:RIO FAMILY NIGHT CLINIC
Entity Type:Organization
Organization Name:RIO FAMILY NIGHT CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARREJO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:956-556-0508
Mailing Address - Street 1:245 WINDWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3350
Mailing Address - Country:US
Mailing Address - Phone:956-556-0508
Mailing Address - Fax:
Practice Address - Street 1:3243 SOUTHMOST RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-4857
Practice Address - Country:US
Practice Address - Phone:956-556-0508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty