Clinica de Pueblo de Palmas, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CLINICA DE PUEBLO DE PALMAS, INC

Practice address

3204 Mile 5 Rd
Mission, TX 78574-6206

Phone

(956) 424-9863

Fax

(956) 424-9868

NPI assigned

Feb 11, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Dee Trevino, RN

Title

Office Manager

Phone

(956) 792-5606

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314576000000",
    "number": "1023315967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 MILE 5 RD",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785746206",
            "telephone_number": "956-424-9863",
            "fax_number": "956-424-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 MILE 5 RD",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785746206",
            "telephone_number": "956-424-9863",
            "fax_number": "956-424-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA DE PUEBLO DE PALMAS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-11",
        "last_updated": "2011-08-29",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "DEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "956-792-5606",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INCORPORATION NUMBER",
            "identifier": "801379109",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Mission, TX
• Providers in Mission, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.