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General NPI Number Information
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NPI Number | 1124660741
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Entity Type | Individual
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Provider Name | MONICA AGRELA
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Gender | Female
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Dates
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Enumeration Date | 10/15/2019
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Last Update Date | 10/15/2019
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Provider Practice Location Address
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Address Line | 7710 W INTERSTATE 10
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City | SAN ANTONIO
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State | TX
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Zip | 78230-4711
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Country | US
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Telephone | 210-377-3355
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Fax |
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Provider Business Mailing Address
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Address Line | 7710 W INTERSTATE 10
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City | SAN ANTONIO
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State | TX
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Zip | 78230-4711
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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