Healthcare Provider Details

I. General information

NPI: 1831277821
Provider Name (Legal Business Name): OBRA HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 11/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 N I RD SUITE B
PHARR TX
78577-1921
US

IV. Provider business mailing address

1225 N I RD SUITE B
PHARR TX
78577-1921
US

V. Phone/Fax

Practice location:
  • Phone: 956-787-6272
  • Fax: 956-787-6289
Mailing address:
  • Phone: 956-787-6272
  • Fax: 956-787-6289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number010290
License Number StateTX

VIII. Authorized Official

Name: MS. MARIA JOVITA PEREZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 956-787-6272