Healthcare Provider Details

I. General information

NPI: 1871834515
Provider Name (Legal Business Name): HAROLD R ALDAPE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2013
Last Update Date: 03/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E US HIGHWAY 83 SUITE A
PHARR TX
78577-5055
US

IV. Provider business mailing address

1000 E US HIGHWAY 83 SUITE A
PHARR TX
78577-5055
US

V. Phone/Fax

Practice location:
  • Phone: 956-283-7048
  • Fax: 956-283-7006
Mailing address:
  • Phone: 956-283-7048
  • Fax: 956-283-7006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number136349
License Number StateTX

VIII. Authorized Official

Name: HAROLD ALDAPE
Title or Position: DIRECTOR
Credential:
Phone: 956-283-7048