St Marie Clinic PA

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

ST MARIE CLINIC PA

Practice address

10900 N 103Rd St
Mission, TX 78573-0979

Phone

(956) 583-7744

Fax

(956) 583-7747

NPI assigned

Aug 14, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Eduardo Carrllo, MD

Title

Owner/Ceo

Phone

(956) 583-7744

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1528071123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E EXPRESSWAY 83",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785725560",
            "telephone_number": "956-585-7401",
            "fax_number": "956-580-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 N 103RD ST",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785730979",
            "telephone_number": "956-583-7744",
            "fax_number": "956-583-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARIE CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "CARRLLO",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "956-583-7744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER #",
            "identifier": "676630",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Clinic/Center in Mission, TX
• Providers in Mission, TX by specialty
• Rehabilitation Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.