Healthcare Provider Details

I. General information

NPI: 1184652372
Provider Name (Legal Business Name): FRIO HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E HACKBERRY ST STE B
PEARSALL TX
78061-4411
US

IV. Provider business mailing address

105 E HACKBERRY ST
PEARSALL TX
78061-4412
US

V. Phone/Fax

Practice location:
  • Phone: 830-334-2058
  • Fax: 830-334-5806
Mailing address:
  • Phone: 830-334-2058
  • Fax: 830-334-5806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number002021
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number0020201
License Number StateTX

VIII. Authorized Official

Name: ERICA SALINAS
Title or Position: ADMINISTRATOR
Credential:
Phone: 830-334-2058