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General NPI Number Information
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NPI Number | 1457883464
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Entity Type | Organization
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Legal Business Name | BRAZOS CARINOSOS INC
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 02/14/2019
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Provider Practice Location Address
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Address Line | 501 E BOWIE
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City | BEEVILLE
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State | TX
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Zip | 78102
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Country | US
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Telephone | 361-358-5559
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Fax | 361-358-6163
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Provider Business Mailing Address
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Address Line | P.O. BOX 533
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City | BEEVILLE
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State | TX
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Zip | 78104
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Country | US
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Telephone | 361-358-5559
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Fax | 361-358-6163
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Authorized Official
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Title or Position | DIRECTOR
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Name | SUSANA GARZA MORON
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Credential | CPA
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Telephone | 361-358-5559
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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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