| Organization Name: | LAREDO FAMILY NITE CLINIC P.A. |
| NPI Number: | 1184924060 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JESUS I AGUIRRE-BURGOS (PRESIDENT) |
| Mailing Address: | 7210 Mcpherson Rd Ste 220 Laredo |
| State: | TX US |
| Postal Code: | 780416505 |
| Phone Number: | 9567299766 |
| Fax Number: | 9567298131 |
| NPI Enumeration Date: | 10/26/2010 |
| NPI Last Update Date: | 06/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | E6206 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |