| St Anthony Family Clinic | |
|
680 Paredes Line Rd Brownsville TX 78521-2482 | |
| (956) 541-9499 | |
| (956) 541-1321 |
| Full Name | St Anthony Family Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 680 Paredes Line Rd, Brownsville, Texas |
| Authorized Official Name and Position | Ronaldo Dictado Factoriza (PHYSICIAN) |
| Authorized Official Contact | 9565419499 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Anthony Family Clinic Po Box 3638 Brownsville TX 78523-3638 Ph: (956) 541-9499 | St Anthony Family Clinic 680 Paredes Line Rd Brownsville TX 78521-2482 Ph: (956) 541-9499 |
| NPI Number | 1679876924 |
|---|---|
| Provider Enumeration Date | 12/08/2010 |
| Last Update Date | 01/04/2011 |
| Medicare PECOS PAC ID | 7113115700 |
|---|---|
| Medicare Enrollment ID | O20101227000062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679876924 | NPI | - | NPPES |
| 046636903 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | K5923 (Texas) | Primary |
| Provider Name | Ronaldo D Factoriza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285607275 PECOS PAC ID: 0749478337 Enrollment ID: I20110105000950 |
| Provider Name | Leticia R Cantu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851739700 PECOS PAC ID: 2264866391 Enrollment ID: I20191226001738 |
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