Healthcare Provider Details

I. General information

NPI: 1194416461
Provider Name (Legal Business Name): ADAPTIVE ACCESS CONSTRUCTION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 07/05/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4205 LORIEMARK DR
MISSION TX
78573-3398
US

IV. Provider business mailing address

4205 LORIEMARK DR
MISSION TX
78573-3398
US

V. Phone/Fax

Practice location:
  • Phone: 956-240-3650
  • Fax: 956-240-3650
Mailing address:
  • Phone: 956-240-3650
  • Fax: 956-519-9922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: JOEL ADRIAN AGUIRRE
Title or Position: OWNER
Credential:
Phone: 956-240-3650