Basic Information
| Provider Information | |||||||||
| NPI: | 1063523140 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TAVAREZ MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 S MAIN ST STE C | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566860574 | ||||||||
| FaxNumber: | 9566863301 | ||||||||
| Practice Location | |||||||||
| Address1: | 801 S MAIN ST STE C | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566860574 | ||||||||
| FaxNumber: | 9566863301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | TAVAREZ | ||||||||
| AuthorizedOfficialFirstName: | HIRAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9566860574 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | E7783 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.