Healthcare Provider Details

I. General information

NPI: 1295894988
Provider Name (Legal Business Name): ADOLFO VALADEZ DBA CIRCLE OF FRIENDS II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 N BROADWAY
ELSA TX
78543
US

IV. Provider business mailing address

RR 6 BOX 535B
EDINBURG TX
78539-8907
US

V. Phone/Fax

Practice location:
  • Phone: 956-262-5555
  • Fax:
Mailing address:
  • Phone: 956-383-4991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number003356
License Number State

VIII. Authorized Official

Name: ADOLFO VALADEZ
Title or Position: OWNER
Credential:
Phone: 956-383-4991