Provider Demographics
NPI:1215112131
Name:RGV PEDIATRIC CRITICAL CARE PA
Entity type:Organization
Organization Name:RGV PEDIATRIC CRITICAL CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:CAMACHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-245-6560
Mailing Address - Street 1:PO BOX 534358
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78553-4358
Mailing Address - Country:US
Mailing Address - Phone:956-421-2414
Mailing Address - Fax:956-421-3321
Practice Address - Street 1:102 N NUECES PARK LN
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-6235
Practice Address - Country:US
Practice Address - Phone:956-421-2414
Practice Address - Fax:956-421-3321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care MedicineGroup - Single Specialty