Healthcare Provider Details

I. General information

NPI: 1003473232
Provider Name (Legal Business Name): RGV GUARDIANS OF CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 05/14/2021
Certification Date: 05/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

848 E EXPRESSWAY 83 STE A
LA JOYA TX
78560-4500
US

IV. Provider business mailing address

PO BOX 487
MISSION TX
78573-0009
US

V. Phone/Fax

Practice location:
  • Phone: 956-599-9111
  • Fax: 956-599-9224
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: DIEGO QUIJANO
Title or Position: ADMINISTRATOR
Credential:
Phone: 956-599-9111