Basic Information
| Provider Information | |||||||||
| NPI: | 1992829550 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HARLINGEN OBSTETRICS & GYNECOLOGY ASSOCIATES, PA | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HARLINGEN OB GYN ASSOCIATES, PA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2230 HAINE DR | ||||||||
| Address2: | |||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785508549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9564254901 | ||||||||
| FaxNumber: | 9564254590 | ||||||||
| Practice Location | |||||||||
| Address1: | 2230 HAINE DR | ||||||||
| Address2: | |||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785508549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9564254901 | ||||||||
| FaxNumber: | 9564254590 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2007 | ||||||||
| LastUpdateDate: | 11/23/2010 | ||||||||
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| AuthorizedOfficialLastName: | AGUILAR | ||||||||
| AuthorizedOfficialFirstName: | MAGGIE | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 9564254901 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | YES | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0000X | J3411 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics |
ID Information
| ID | Type | State | Issuer | Description | 129251803 | 05 | TX | MEDICAID | 136856504 | 05 | TX | MEDICAID |