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General NPI Number Information
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NPI Number | 1477612174
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Entity Type | Organization
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Legal Business Name | ADOLFO SQUARE INC.
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 04/29/2024
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Provider Practice Location Address
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Address Line | 515 N. FM 1015
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City | PROGRESO
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State | TX
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Zip | 78579
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Country | US
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Telephone | 956-565-9105
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Fax |
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Provider Business Mailing Address
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Address Line | RR 6 BOX 535B
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City | EDINBURG
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State | TX
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Zip | 78539-8907
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Country | US
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Telephone | 956-383-4991
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ADOLFO VALADEZ
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Credential |
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Telephone | 956-383-4991
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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 | 003334
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License Number State | TX
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