Provider Demographics
NPI:1750692885
Name:EDINBURG OBSTETRICS GYNECOLOGY & INFERTILITY CLINIC PA
Entity type:Organization
Organization Name:EDINBURG OBSTETRICS GYNECOLOGY & INFERTILITY CLINIC PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADA
Authorized Official - Middle Name:XOCHILTE
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-380-3441
Mailing Address - Street 1:3001 N 23RD ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-6179
Mailing Address - Country:US
Mailing Address - Phone:956-661-0044
Mailing Address - Fax:956-994-0745
Practice Address - Street 1:3001 N 23RD ST STE 1
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-6179
Practice Address - Country:US
Practice Address - Phone:956-661-0044
Practice Address - Fax:956-994-0745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty