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General NPI Number Information
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NPI Number | 1467608067
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Entity Type | Organization
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Legal Business Name | LAGUNA HEALTHCARE
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 8105 E 14TH ST
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City | BROWNSVILLE
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State | TX
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Zip | 78521-6601
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Country | US
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Telephone | 956-838-2222
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6266
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City | BROWNSVILLE
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State | TX
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Zip | 78523-6266
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Country | US
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Telephone | 956-838-2222
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MR. HAROLD FINNER TAYLOR
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Credential |
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Telephone | 956-838-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | NULL
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