Provider Demographics
NPI:1790847887
Name:COMMUNITY ACTION COUNCIL OF SOUTH TEXAS
Entity Type:Organization
Organization Name:COMMUNITY ACTION COUNCIL OF SOUTH TEXAS
Other - Org Name:LA MISION DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:G
Authorized Official - Last Name:ZARATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-487-2585
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-0098
Mailing Address - Country:US
Mailing Address - Phone:956-487-2585
Mailing Address - Fax:956-487-6670
Practice Address - Street 1:600 N GARZA ST
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-3538
Practice Address - Country:US
Practice Address - Phone:956-487-2585
Practice Address - Fax:956-487-6670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty