Healthcare Provider Details

I. General information

NPI: 1780617696
Provider Name (Legal Business Name): CHAMPION CARE OF ZAPATA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2408 NORTH U.S. HIGHWAY 83 SUITE 2
ZAPATA TX
78076-0000
US

IV. Provider business mailing address

2408 NORTH U.S. HIGHWAY 83 SUITE 2
ZAPATA TX
78076-0000
US

V. Phone/Fax

Practice location:
  • Phone: 956-765-1111
  • Fax: 956-765-5084
Mailing address:
  • Phone: 956-765-1111
  • Fax: 956-765-5084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: VELMA NOEMI BARRERA-DECKER
Title or Position: OWNER ADMINISTRATOR
Credential:
Phone: 956-765-1111