Avila Family Practice Clinic PA

Organization Active NPI Family Medicine Physician · Donna, TX

NPI 1124560495 · NPPES record last updated Nov 17, 2016

Key facts

NPI
1124560495
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
AVILA FAMILY PRACTICE CLINIC PA
Practice address
308 N Salinas Blvd
Donna, TX 78537-2930
Phone
(956) 464-4497
NPI assigned
Nov 17, 2016
Organization subpart
No

Authorized official

Name
Julio Avila, PA-C
Title
Physician Assistant
Phone
(956) 464-4497

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20170218000060 TX Part B Supplier - Clinic/Group Practice 3274816186 Receives reassigned benefits from 2 practitioners
Practice locations: Donna, TX

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

308 N Salinas Blvd
Donna, TX 78537-2930

Mailing address

308 N Salinas Blvd
Donna, TX 78537-2930

Other providers in Donna, TX

All providers in Donna, TX · Family Medicine Physician in Texas

Sources for this page

Verify at the official NPI Registry.