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General NPI Number Information
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NPI Number | 1912677550
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Entity Type | Organization
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Legal Business Name | HERMOSA VICTORIA PROVIDER AGENCY LLC
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Dates
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Enumeration Date | 09/15/2021
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2511 BUDDY OWENS AVE STE E
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City | MCALLEN
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State | TX
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Zip | 78504-5427
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Country | US
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Telephone | 956-321-9067
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Fax | 956-992-1327
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Provider Business Mailing Address
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Address Line | 1960 ZENAIDA AVE
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City | MCALLEN
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State | TX
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Zip | 78504-5625
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Country | US
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Telephone | 956-321-9067
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Fax | 956-992-1327
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JAVIER HERNANDEZ JR.
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Credential |
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Telephone | 956-321-9067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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