Provider Demographics
NPI:1528010782
Name:P I MEDICAL DAY & NIGHT CLINIC
Entity Type:Organization
Organization Name:P I MEDICAL DAY & NIGHT CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-943-6675
Mailing Address - Street 1:1200 HIGHWAY 100
Mailing Address - Street 2:STE 5
Mailing Address - City:PORT ISABEL
Mailing Address - State:TX
Mailing Address - Zip Code:78578-2462
Mailing Address - Country:US
Mailing Address - Phone:956-943-6675
Mailing Address - Fax:956-943-6864
Practice Address - Street 1:1200 HIGHWAY 100
Practice Address - Street 2:STE 5
Practice Address - City:PORT ISABEL
Practice Address - State:TX
Practice Address - Zip Code:78578-2450
Practice Address - Country:US
Practice Address - Phone:956-943-6675
Practice Address - Fax:956-943-6864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX673826Medicare Oscar/Certification