Healthcare Provider Details

I. General information

NPI: 1821421439
Provider Name (Legal Business Name): LA GLORIA HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 08/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 FAIR AVE STE B
SAN ANTONIO TX
78223-1327
US

IV. Provider business mailing address

PO BOX 33785
SAN ANTONIO TX
78265-3785
US

V. Phone/Fax

Practice location:
  • Phone: 210-323-1365
  • Fax:
Mailing address:
  • Phone: 210-323-1365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. BARBARA SALINAS
Title or Position: GENERAL MANAGER
Credential:
Phone: 210-323-1365