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General NPI Number Information
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NPI Number | 1558422063
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Entity Type | Organization
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Legal Business Name | GUADALUPE MEDICAL INNOVATIONS
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 07/28/2007
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Provider Practice Location Address
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Address Line | 114 TRADE AVE
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City | BOERNE
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State | TX
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Zip | 78006-3001
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Country | US
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Telephone | 830-816-2552
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Fax |
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Provider Business Mailing Address
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Address Line | 114 TRADE AVE
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City | BOERNE
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State | TX
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Zip | 78006-3001
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Country | US
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Telephone | 830-816-2552
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Fax |
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Authorized Official
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Title or Position | BUSINESS ADMINISTRATOR
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Name | MS. CLAUDIA CABRAL
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Credential |
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Telephone | 830-816-2552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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