Basic Information
| Provider Information | |||||||||
| NPI: | 1134422611 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RIO GRANDE VALLEY PHYSICIANS, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 LINDBERG AVE | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785012928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566272483 | ||||||||
| FaxNumber: | 9566272677 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 LINDBERG AVE | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785012928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566272483 | ||||||||
| FaxNumber: | 9566272677 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2010 | ||||||||
| LastUpdateDate: | 12/22/2021 | ||||||||
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| AuthorizedOfficialLastName: | MUNOZ | ||||||||
| AuthorizedOfficialFirstName: | WILFREDO | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9566272483 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 12/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 305450402 | 05 | TX | MEDICAID | DT2234 | 01 | TX | RR MEDICARE | OTHER | 0059WC | 01 | TX | BCBS | OTHER |