Provider Demographics
NPI:1609498716
Name:NORTH MCALLEN PEDIATRIC CENTER
Entity Type:Organization
Organization Name:NORTH MCALLEN PEDIATRIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAN JUANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-283-1889
Mailing Address - Street 1:807 N CAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-3117
Mailing Address - Country:US
Mailing Address - Phone:956-283-1889
Mailing Address - Fax:956-283-7014
Practice Address - Street 1:801 E NOLANA AVE STE 1
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6113
Practice Address - Country:US
Practice Address - Phone:956-283-1889
Practice Address - Fax:956-283-7014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty