Provider Demographics
NPI:1982733812
Name:RGV HARLINGEN FAMILY NIGHT CLINIC, PA
Entity Type:Organization
Organization Name:RGV HARLINGEN FAMILY NIGHT CLINIC, PA
Other - Org Name:HARLINGEN FAMILY NIGHT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUCEDA
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:956-423-1283
Mailing Address - Street 1:2226 HAINE DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8549
Mailing Address - Country:US
Mailing Address - Phone:956-423-1283
Mailing Address - Fax:956-412-3033
Practice Address - Street 1:2226 HAINE DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8549
Practice Address - Country:US
Practice Address - Phone:956-423-0085
Practice Address - Fax:956-412-3033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187365507Medicaid
TX093756701Medicaid