=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033706460
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PALOMA PHC SERVICES, LLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/31/2020
-----------------------------------------------------
Last Update Date | 12/12/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 725 N WARE RD STE C
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78501-6616
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-322-3961
-----------------------------------------------------
Fax | 956-322-3967
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 725 N WARE RD STE C
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78501-6616
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-322-3961
-----------------------------------------------------
Fax | 956-322-3967
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | CASEY ALI RAMIREZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 956-533-2064
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------