Provider Demographics
NPI:1144850520
Name:HELLEN RURANGIRWA MD PA PEDIATRIC CLINIC
Entity type:Organization
Organization Name:HELLEN RURANGIRWA MD PA PEDIATRIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RURANGIRWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-832-4924
Mailing Address - Street 1:5940 HIDDEN HIDEAWAY
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-4066
Mailing Address - Country:US
Mailing Address - Phone:956-832-4924
Mailing Address - Fax:
Practice Address - Street 1:2648 W ALTON GLOOR
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520
Practice Address - Country:US
Practice Address - Phone:956-832-4924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty