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General NPI Number Information
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NPI Number | 1972943165
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Entity Type | Organization
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Legal Business Name | GLORY PRIMARY HOME CARE INC.
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Dates
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Enumeration Date | 07/02/2013
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Last Update Date | 07/02/2013
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Provider Practice Location Address
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Address Line | 609 S RESPLANDOR ST
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City | MISSION
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State | TX
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Zip | 78572-6911
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Country | US
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Telephone | 956-309-3433
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Fax |
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Provider Business Mailing Address
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Address Line | 609 S RESPLANDOR ST
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City | MISSION
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State | TX
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Zip | 78572-6911
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. GLORIA GARCIA
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Credential |
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Telephone | 956-309-3433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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License Number State |
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