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General NPI Number Information
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NPI Number | 1669790093
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Entity Type | Organization
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Legal Business Name | YOUR KEY TO HEALTH, INC.
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Dates
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Enumeration Date | 05/10/2010
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Last Update Date | 05/10/2010
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Provider Practice Location Address
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Address Line | 625 E PRICE RD
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City | BROWNSVILLE
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State | TX
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Zip | 78521-4215
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Country | US
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Telephone | 956-541-4414
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Fax | 956-541-4418
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Provider Business Mailing Address
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Address Line | 1652 WESTMINSTER RD
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City | BROWNSVILLE
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State | TX
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Zip | 78521-3612
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Country | US
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Telephone | 956-541-4414
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Fax | 956-541-4418
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. SUSAN Z EBERSOLE
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Credential | MBA
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Telephone | 956-541-4414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | F8432
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License Number State | TX
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