Healthcare Provider Details

I. General information

NPI: 1801301114
Provider Name (Legal Business Name): RGV COMPASSIONATE CARE PROVIDERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2017
Last Update Date: 12/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 E GRIFFIN PKWY
MISSION TX
78572-3301
US

IV. Provider business mailing address

2411 E. GRIFFIN PKWY
MISSION TX
78572
US

V. Phone/Fax

Practice location:
  • Phone: 956-581-9450
  • Fax:
Mailing address:
  • Phone: 956-581-9450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. PETER MATTHEW FOX
Title or Position: DIRECTOR
Credential:
Phone: 956-581-9450