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General NPI Number Information
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NPI Number | 1205960952
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Entity Type | Organization
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Legal Business Name | MAIDA DURAN
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2311 S. CLOSNER
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City | EDINBURG
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State | TX
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Zip | 78539
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Country | US
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Telephone | 956-387-0388
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Fax |
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Provider Business Mailing Address
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Address Line | 2311 S. CLOSNER
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City | EDINBURG
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State | TX
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Zip | 78539
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Country | US
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Telephone | 956-387-0388
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MAIDA DURAN
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Credential |
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Telephone | 956-387-0388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number | 010302
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License Number State | TX
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