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General NPI Number Information
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NPI Number | 1033395223
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Entity Type | Organization
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Legal Business Name | PAX VILLA, INC.
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 01/02/2020
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Provider Practice Location Address
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Address Line | 4513 W BUSINESS HIGHWAY 83
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City | MCALLEN
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State | TX
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Zip | 78502-9701
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Country | US
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Telephone | 956-686-4414
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5957
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City | MCALLEN
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State | TX
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Zip | 78502-5957
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Country | US
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Telephone | 956-821-8423
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MR. SAMUEL ETIENNE
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Credential |
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Telephone | 956-821-8423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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