Provider Demographics
NPI:1679725915
Name:RGV DAY & NIGHT CLINIC LLC
Entity Type:Organization
Organization Name:RGV DAY & NIGHT CLINIC LLC
Other - Org Name:MEDICAL ASSOCIATES OF BROWNSVILLE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TRYKA
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CPMA
Authorized Official - Phone:956-546-3116
Mailing Address - Street 1:425 E LOS EBANOS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8481
Mailing Address - Country:US
Mailing Address - Phone:956-546-3116
Mailing Address - Fax:956-546-8793
Practice Address - Street 1:425 E LOS EBANOS BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8481
Practice Address - Country:US
Practice Address - Phone:956-542-2520
Practice Address - Fax:956-544-2580
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL ASSOCIATES OF BROWNSVILLE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-17
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080669701Medicaid
TX00480NMedicare PIN