Provider Demographics
NPI:1124751896
Name:PROFESSIONAL PSYCHIATRIC ASSOCIATES OF RGV, PLLC
Entity type:Organization
Organization Name:PROFESSIONAL PSYCHIATRIC ASSOCIATES OF RGV, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-377-5400
Mailing Address - Street 1:104 NORTH SALINAS BLVD
Mailing Address - Street 2:SUITE -A
Mailing Address - City:DONNA
Mailing Address - State:TX
Mailing Address - Zip Code:78537
Mailing Address - Country:US
Mailing Address - Phone:956-377-5710
Mailing Address - Fax:956-377-5509
Practice Address - Street 1:104 NORTH SALINAS BLVD
Practice Address - Street 2:SUITE-A
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537
Practice Address - Country:US
Practice Address - Phone:956-377-5400
Practice Address - Fax:956-377-5509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-08
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty