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General NPI Number Information
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NPI Number | 1588670277
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Entity Type | Organization
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Legal Business Name | PARA NINOS DEL VALLE PEDIATRIC HOME HEALTH, PLLC
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 1650 RUSSELL LN
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City | SAN BENITO
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State | TX
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Zip | 78586-7626
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Country | US
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Telephone | 956-626-1385
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Fax | 956-626-1392
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Provider Business Mailing Address
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Address Line | 1650 RUSSELL LN
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City | SAN BENITO
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State | TX
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Zip | 78586-7626
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Country | US
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Telephone | 956-626-1385
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Fax | 956-626-1392
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Authorized Official
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Title or Position | OWNER
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Name | CAROLINA C GONZALEZ
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Credential | RN
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Telephone | 956-626-1385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 009058
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 009058
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 009058
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License Number State | TX
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