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General NPI Number Information
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NPI Number | 1053068585
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Entity Type | Organization
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Legal Business Name | FAMILY PROVIDER SERVICE, LLC.
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Dates
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Enumeration Date | 03/04/2022
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1022 E. GRIFFIN PKWY
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City | MISSION
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State | TX
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Zip | 78572-2401
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Country | US
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Telephone | 210-233-6584
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Fax | 210-750-1283
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Provider Business Mailing Address
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Address Line | 1022 E. GRIFFIN PKWY
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City | MISSION
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State | TX
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Zip | 78572-2401
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Country | US
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Telephone | 210-233-6584
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Fax | 210-750-1283
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Authorized Official
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Title or Position | CEO
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Name | DANIEL VILLALOBOS
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Credential |
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Telephone | 210-233-6584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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