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General NPI Number Information
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NPI Number | 1225211691
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Entity Type | Organization
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Legal Business Name | DELEON PRIMARY HOME CARE, INC.
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Dates
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Enumeration Date | 12/08/2007
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Last Update Date | 12/08/2007
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Provider Practice Location Address
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Address Line | 1519 WASHINGTON ST SUITE 1
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City | LAREDO
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State | TX
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Zip | 78040-4412
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Country | US
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Telephone | 956-727-7775
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Fax | 956-727-7778
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Provider Business Mailing Address
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Address Line | 1519 WASHINGTON ST SUITE 1
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City | LAREDO
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State | TX
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Zip | 78040-4412
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Country | US
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Telephone | 956-727-7775
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Fax | 956-727-7778
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. GUADALUPE DELEON
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Credential |
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Telephone | 956-727-7775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 010913
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License Number State | TX
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