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General NPI Number Information
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NPI Number | 1053926972
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Entity Type | Organization
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Legal Business Name | EL ALFARERO Y YO PHC, LLC
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Dates
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Enumeration Date | 09/09/2020
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | 209 E A GUTIERREZ
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City | EDCOUCH
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State | TX
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Zip | 78538-7853
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Country | US
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Telephone | 956-272-1965
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Fax | 956-517-1498
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Provider Business Mailing Address
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Address Line | PO BOX 487
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City | EDCOUCH
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State | TX
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Zip | 78538-0487
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Country | US
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Telephone | 956-272-1965
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Fax | 956-517-1498
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Authorized Official
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Title or Position | OWNER
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Name | MARIA GUADALUPE GARZA
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Credential |
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Telephone | 956-272-1965
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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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