Provider Demographics
NPI:1437436151
Name:COLUMBIA RIO GRANDE HEALTHCARE LP
Entity Type:Organization
Organization Name:COLUMBIA RIO GRANDE HEALTHCARE LP
Other - Org Name:RIO GRANDE WOMEN'S CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-632-6149
Mailing Address - Street 1:222 E RIDGE RD
Mailing Address - Street 2:STE. 101
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1251
Mailing Address - Country:US
Mailing Address - Phone:956-632-6032
Mailing Address - Fax:956-971-9539
Practice Address - Street 1:222 E RIDGE RD
Practice Address - Street 2:STE. 101
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1251
Practice Address - Country:US
Practice Address - Phone:956-632-6032
Practice Address - Fax:956-971-9539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX558605363LP1700X
TX242863363LP1700X
TX234002363LW0102X
TX625642363LW0102X
363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty
No363LP1700XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPerinatalGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0883035Medicaid
TX3119380Medicaid
TX0707945Medicaid
TX1127169Medicaid
TX1711186Medicaid