Healthcare Provider Details

I. General information

NPI: 1285672253
Provider Name (Legal Business Name): KIRBY & RUSS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 W SANTA ROSA AVE
EDCOUCH TX
78538-3103
US

IV. Provider business mailing address

PO BOX 175
WESLACO TX
78599-0175
US

V. Phone/Fax

Practice location:
  • Phone: 956-262-2401
  • Fax: 956-262-2400
Mailing address:
  • Phone: 956-262-2401
  • Fax: 956-262-2400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number010618
License Number StateTX

VIII. Authorized Official

Name: EDELMIRO VARELA
Title or Position: C.E.O./PRESIDENT/ADMINISTRATOR
Credential: R.N.
Phone: 956-262-2401