Healthcare Provider Details

I. General information

NPI: 1932664372
Provider Name (Legal Business Name): SOCORRO HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2019
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10064 ALAMEDA AVE
SOCORRO TX
79927-1801
US

IV. Provider business mailing address

10064 ALAMEDA AVE
SOCORRO TX
79927-1801
US

V. Phone/Fax

Practice location:
  • Phone: 915-995-7230
  • Fax: 915-790-0612
Mailing address:
  • Phone: 915-995-7230
  • Fax: 915-790-0612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: PHILLIP TEAGUE
Title or Position: PRESIDENT
Credential:
Phone: 915-995-7230