NPIMap

Organization Active NPI

Rural Clinics of South Texas, LLC

  • Rural Health Clinic/Center
  • Port Isabel, TX
National Provider Identifier
1962536573
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
E2903 Issued in TX
Legal business name
RURAL CLINICS OF SOUTH TEXAS, LLC
Practice address
202 2ND St
Port Isabel, TX 78578-4100
Phone
(956) 943-1774
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Dr. William H Torkildsen, M.DNPI 1740287051
Title
President
Phone
(956) 943-1774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X E2903 TX Primary

Addresses

Primary practice location

202 2ND St
Port Isabel, TX 78578-4100

Mailing address

202 2ND St
Port Isabel, TX 78578-4100
Phone (956) 943-1774

Other names 1

  • Port Isabel Health Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041022000735 TX Part B Supplier - Clinic/Group Practice 5799746780 Receives reassigned benefits from 2 practitioners
Practice locations: Port Isabel, TX
O20071227000204 TX Part A Provider - Rural Health Clinic 5799746780 Practice locations: Port Isabel, TX

Rural health clinic certification: CCN 458923

Legal name
RURAL CLINICS OF SOUTH TEXAS, LLC
Doing business as
PORT ISABEL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 18, 1995
Last certification
Jul 7, 2022
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
May 30, 1995 in TX
Enrollment address
202 2ND Street
Port Isabel Health Clinic
Port Isabel, TX 78578-4100

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0901462Port Isabel Health Clinic202 2ND Street, Port Isabel, TX 78578Certificate of waiverMay 23, 2027

National Provider Directory

National Provider Directory

Locations

202 2nd St
Port Isabel, TX 78578
Phone (956) 943-1774

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ivy Lynn Murchison Individual W-2 Managing EmployeeOffice Manager Dec 1, 2015 100%
William H Torkildsen Individual 5% Or Greater Direct Ownership Interest May 30, 1995
Corporate Director May 30, 1995

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1962536573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 2ND ST",
            "city": "PORT ISABEL",
            "state": "TX",
            "postal_code": "785784100",
            "telephone_number": "956-943-1774",
            "fax_number": "956-943-7938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 2ND ST",
            "city": "PORT ISABEL",
            "state": "TX",
            "postal_code": "785784100",
            "telephone_number": "956-943-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL CLINICS OF SOUTH TEXAS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "TORKILDSEN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "956-943-1774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TX",
            "license": "E2903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Port Isabel Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Isabel, TX

Sources for this page

Verify at the official NPI Registry.