Healthcare Provider Details

I. General information

NPI: 1790974525
Provider Name (Legal Business Name): DEL VALLE LAS MANITAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5510 N CAGE BLVD SUITE 'N'
PHARR TX
78577-1812
US

IV. Provider business mailing address

5510 N CAGE BLVD SUITE 'N'
PHARR TX
78577-1812
US

V. Phone/Fax

Practice location:
  • Phone: 956-782-9009
  • Fax: 956-782-9809
Mailing address:
  • Phone: 956-782-9009
  • Fax: 956-782-9809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1012668
License Number StateTX

VIII. Authorized Official

Name: MS. NORA GARCIA DE LEON
Title or Position: DIRECTOR
Credential: J.D.
Phone: 956-782-9009