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General NPI Number Information
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NPI Number | 1508558651
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Entity Type | Organization
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Legal Business Name | COUNTY OF LA SALLE
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Dates
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Enumeration Date | 05/25/2023
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 627 N BAYLOR ST
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City | COTULLA
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State | TX
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Zip | 78014
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Country | US
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Telephone | 830-483-5260
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Fax | 830-483-5865
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Provider Business Mailing Address
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Address Line | 300 SANTANA ROW STE 300
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City | SAN JOSE
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State | CA
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Zip | 95128-2424
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Country | US
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Telephone | 669-236-5953
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Fax |
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Authorized Official
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Title or Position | COUNTY JUDGE
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Name | LEODORO MARTINEZ III
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Credential |
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Telephone | 830-483-5139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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