Healthcare Provider Details

I. General information

NPI: 1093957623
Provider Name (Legal Business Name): M-PRO ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2009
Last Update Date: 10/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2711 S JACKSON RD
PHARR TX
78577-4794
US

IV. Provider business mailing address

2711 S JACKSON RD
PHARR TX
78577-4794
US

V. Phone/Fax

Practice location:
  • Phone: 956-664-1153
  • Fax: 956-223-4462
Mailing address:
  • Phone: 956-664-1153
  • Fax: 956-223-4462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MISS YESENIA L GOMEZ
Title or Position: OWNER/MANAGER
Credential:
Phone: 956-664-1153