Provider Demographics
NPI:1457069056
Name:RAYMONDVILLE ISD HEALTH CLINIC
Entity Type:Organization
Organization Name:RAYMONDVILLE ISD HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLINTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-689-8181
Mailing Address - Street 1:419 FM 3168
Mailing Address - Street 2:
Mailing Address - City:RAYMONDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78580-4443
Mailing Address - Country:US
Mailing Address - Phone:956-689-8175
Mailing Address - Fax:956-689-8180
Practice Address - Street 1:419 FM 3168
Practice Address - Street 2:
Practice Address - City:RAYMONDVILLE
Practice Address - State:TX
Practice Address - Zip Code:78580-4443
Practice Address - Country:US
Practice Address - Phone:956-689-8175
Practice Address - Fax:956-689-8180
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAYMONDVILLE INDEPENDENT SCHOOL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty