Provider Demographics
NPI:1508086497
Name:DONNA MEDICAL CLINIC
Entity Type:Organization
Organization Name:DONNA MEDICAL CLINIC
Other - Org Name:DONNA DAY & NIGHT CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:BERTHA
Authorized Official - Middle Name:JULIA
Authorized Official - Last Name:DAVILA-HOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:956-464-2402
Mailing Address - Street 1:307 N SALINAS BLVD
Mailing Address - Street 2:
Mailing Address - City:DONNA
Mailing Address - State:TX
Mailing Address - Zip Code:78537-2929
Mailing Address - Country:US
Mailing Address - Phone:956-464-2402
Mailing Address - Fax:956-464-4709
Practice Address - Street 1:307 N SALINAS BLVD
Practice Address - Street 2:
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537-2929
Practice Address - Country:US
Practice Address - Phone:956-464-2402
Practice Address - Fax:956-464-4709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent MedicineGroup - Multi-Specialty