Healthcare Provider Details

I. General information

NPI: 1114106218
Provider Name (Legal Business Name): BRIONES VENTRURES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2007
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 N CAGE BLVD
PHARR TX
78577-3906
US

IV. Provider business mailing address

220 N CAGE BLVD
PHARR TX
78577-3906
US

V. Phone/Fax

Practice location:
  • Phone: 956-283-9595
  • Fax: 956-283-9414
Mailing address:
  • Phone: 956-283-9595
  • Fax: 956-283-9414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number120004
License Number StateTX

VIII. Authorized Official

Name: MR. CRUZ BRIONES
Title or Position: PRESIDENT
Credential:
Phone: 956-283-9595