Healthcare Provider Details

I. General information

NPI: 1306040076
Provider Name (Legal Business Name): EL PARQUE ADULT DAY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1639 E HWY 83 SUITE F
RIO GRANDE CITY TX
78582-3120
US

IV. Provider business mailing address

801 W MAIN ST
RIO GRANDE CITY TX
78582-3120
US

V. Phone/Fax

Practice location:
  • Phone: 956-487-7343
  • Fax: 956-488-0383
Mailing address:
  • Phone: 956-487-2097
  • Fax: 956-488-0383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number118837
License Number StateTX

VIII. Authorized Official

Name: MARIA LYDIA GARZA
Title or Position: OWNER
Credential:
Phone: 956-487-2097