Provider E-Newsletter

Complete the form to start receiving Driscoll Health Plan's Provider e-newsletter. Please contact Provider Relations at 956-632-8308 if you have any questions.

Items with an * are required information.
Contact Name *

First NameLast Name
Position or Role
Practice or Group Name*
Email Address *
example@example.com
Confirm Email Address *
example@example.com
Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Tax Identification Number (TIN) *
9 digit number
Additional Tax Identification Number(s) (TIN)
9 digit number
National Provider Identifier (NPI) *
10 digit number
Service Delivery Area (SDA) (select all that apply)

Nueces SDAHidalgo SDA
Line of Business (select all that apply) *

STARSTAR KidsCHIP
Provider Specialty Type (select all that apply) *

Adult Day Care or Assisted LivingAllergy or ImmunologyAmbulatoryAnesthesiaAudiologyBehavioral Health or CounselorCardiologyCritical Care or Emergency MedicineDermatologyDurable Medical Equipment (DME)Ear, Nose and ThroatEndocrinologyFederally Qualified Health Center (FQHC)GastroentrologyHome HealthHospitalInterventional Pain ManagementLong-Term Services and Supports (LTSS)NeurologyNephrologyOB/GYNOrthopedicsOptometryOncologyPathologyPharmacyPediatricsPodiatryPrimary Care Provider (PCP)PulmonologyRural Health Cinic (RHC)Therapy (Physical/Occupational/Speech)UrologyOther
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