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General NPI Number Information
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NPI Number | 1508927112
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Entity Type | Organization
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Legal Business Name | CARESTAT PROVIDER SERVICES
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 01/13/2010
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Provider Practice Location Address
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Address Line | 406 ALTO ST
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City | ALICE
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State | TX
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Zip | 78332-5908
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Country | US
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Telephone | 956-664-1213
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Fax | 956-664-2449
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Provider Business Mailing Address
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Address Line | 406 ALTO ST
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City | ALICE
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State | TX
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Zip | 78332-5908
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Country | US
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Telephone | 956-664-1213
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Fax | 956-664-2449
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Authorized Official
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Title or Position | PRESIDENT
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Name | OSCAR BARRERA
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Credential |
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Telephone | 956-664-1213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 1699780478
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License Number State | TX
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