Provider Demographics
NPI:1922304336
Name:INSPIRATION FAMILY MEDICAL CLINIC, PLLC
Entity Type:Organization
Organization Name:INSPIRATION FAMILY MEDICAL CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:IGNACIO
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:II
Authorized Official - Credentials:FNP
Authorized Official - Phone:956-583-6737
Mailing Address - Street 1:PO BOX 5728
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-5728
Mailing Address - Country:US
Mailing Address - Phone:956-994-0026
Mailing Address - Fax:956-994-0032
Practice Address - Street 1:2009 W 3 MILE LINE
Practice Address - Street 2:SUITE 700
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572
Practice Address - Country:US
Practice Address - Phone:956-994-0026
Practice Address - Fax:956-994-0032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX684975363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty