Provider Demographics
NPI:1013033141
Name:RALPH NIMCHAN MD PA
Entity type:Organization
Organization Name:RALPH NIMCHAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:NIMCHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-723-0462
Mailing Address - Street 1:6801 MCPHERSON RD
Mailing Address - Street 2:SUITE 226
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6402
Mailing Address - Country:US
Mailing Address - Phone:956-723-0462
Mailing Address - Fax:956-723-6547
Practice Address - Street 1:6801 MCPHERSON RD
Practice Address - Street 2:SUITE 226
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6402
Practice Address - Country:US
Practice Address - Phone:956-723-0462
Practice Address - Fax:956-723-6547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3075174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC19913Medicare UPIN
TX00R399Medicare ID - Type Unspecified