Basic Information
| Provider Information | |||||||||
| NPI: | 1710180732 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEBBRONVILLE HEALTH CLINIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 98 | ||||||||
| Address2: | |||||||||
| City: | RIO GRANDE CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785820098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9564873928 | ||||||||
| FaxNumber: | 9564876670 | ||||||||
| Practice Location | |||||||||
| Address1: | 473 EAST STATE HWY 285 | ||||||||
| Address2: | |||||||||
| City: | HEBBRONVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3615274053 | ||||||||
| FaxNumber: | 3615275109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | CANTU | ||||||||
| AuthorizedOfficialFirstName: | JUAN | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | INTERM EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9564872585 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA0005X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Family Planning Facility |
No ID Information.