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General NPI Number Information
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NPI Number | 1598967861
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Entity Type | Organization
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Legal Business Name | GUSTAVO GARCIA & SYLVIA GARCIA
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 811 E PIKE BLVD
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City | WESLACO
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State | TX
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Zip | 78596-4935
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Country | US
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Telephone | 956-969-2472
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Fax | 956-447-2207
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Provider Business Mailing Address
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Address Line | 811 E PIKE BLVD
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City | WESLACO
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State | TX
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Zip | 78596-4935
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Country | US
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Telephone | 956-969-2472
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Fax | 956-447-2207
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. GUSTAVO GARCIA
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Credential | LVN
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Telephone | 956-969-2472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number | 006547
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License Number State | TX
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