Healthcare Provider Details

I. General information

NPI: 1740374180
Provider Name (Legal Business Name): PTL HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 UPTOWN AVE STE B
BROWNSVILLE TX
78520-7559
US

IV. Provider business mailing address

130 UPTOWN AVE STE B
BROWNSVILLE TX
78520-7559
US

V. Phone/Fax

Practice location:
  • Phone: 956-838-1801
  • Fax: 956-838-0170
Mailing address:
  • Phone: 956-838-1801
  • Fax: 956-838-0170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number009392
License Number StateTX

VIII. Authorized Official

Name: ROSAURA BOTELLO
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 956-838-1801