Healthcare Provider Details

I. General information

NPI: 1093099764
Provider Name (Legal Business Name): PBJ ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2011
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 S RAUL LONGORIA RD
EDINBURG TX
78542-6466
US

IV. Provider business mailing address

1212 S RAUL LONGORIA RD
EDINBURG TX
78542-6466
US

V. Phone/Fax

Practice location:
  • Phone: 956-513-1022
  • Fax: 956-513-1031
Mailing address:
  • Phone: 956-513-1022
  • Fax: 956-513-1031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number103169
License Number StateTX

VIII. Authorized Official

Name: CINDY DAVILA
Title or Position: MANAGING MEMBER
Credential:
Phone: 956-513-1022