Healthcare Provider Details

I. General information

NPI: 1194903237
Provider Name (Legal Business Name): SOUTH TEXAS ELDERLY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 06/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E RAMON AYALA DR
HIDALGO TX
78557-2691
US

IV. Provider business mailing address

500 E RAMON AYALA DR
HIDALGO TX
78557-2691
US

V. Phone/Fax

Practice location:
  • Phone: 956-843-2643
  • Fax: 956-843-2288
Mailing address:
  • Phone: 956-843-2643
  • Fax: 956-843-2288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number122232
License Number StateTX

VIII. Authorized Official

Name: MR. RAYMUNDO MARTINEZ
Title or Position: DIRECTOR
Credential:
Phone: 956-843-2643