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General NPI Number Information
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NPI Number | 1205162815
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Entity Type | Organization
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Legal Business Name | J G BURCIAGA ENTERPRISES, INC.
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Dates
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Enumeration Date | 11/02/2009
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Last Update Date | 11/02/2009
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Provider Practice Location Address
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Address Line | 216 E. EXPRESSWAY 83 SUITE K OFFICE A
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City | PHARR
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State | TX
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Zip | 78577
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Country | US
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Telephone | 956-223-2575
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Fax | 956-783-1836
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Provider Business Mailing Address
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Address Line | PO BOX 9
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City | SAN JUAN
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State | TX
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Zip | 78589-0009
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Country | US
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Telephone | 956-223-2575
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Fax | 956-783-1836
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Authorized Official
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Title or Position | PRESIDENT/REGISTERED AGENT
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Name | MR. JUAN GABRIEL BURCIAGA
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Credential |
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Telephone | 956-605-9887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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