| Southside Night Clinic | |
|
717 Savannah Ave Mcallen TX 78503-3006 | |
| (956) 631-5995 | |
| (956) 631-1372 |
| Full Name | Southside Night Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 717 Savannah Ave, Mcallen, Texas |
| Authorized Official Name and Position | Bertha L. Rodriguez-medina (PHYSICIAN/OWNER) |
| Authorized Official Contact | 9566315995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Night Clinic 717 Savannah Ave Mcallen TX 78503-3006 Ph: (956) 631-5995 | Southside Night Clinic 717 Savannah Ave Mcallen TX 78503-3006 Ph: (956) 631-5995 |
| NPI Number | 1396790994 |
|---|---|
| Provider Enumeration Date | 05/23/2006 |
| Last Update Date | 10/27/2023 |
| Certification Date | 10/27/2023 |
| Medicare PECOS PAC ID | 3274827514 |
|---|---|
| Medicare Enrollment ID | O20160809001075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396790994 | NPI | - | NPPES |
| 092136301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| Provider Name | Bertha Laura Rodriguez-medina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811048143 PECOS PAC ID: 2860655628 Enrollment ID: I20120516000265 |
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