MEDICARE: MAIDA DURAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311Z00000X	Custodial Care Facility	010302	TX

General Provider Information

NPI Number	:	1205960952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAIDA DURAN

Provider Business Mailing Address
First Line	:	2311 S. CLOSNER
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539
Country	:	US
Telephone Number	:	956-387-0388
Fax Number	:

Provider Business Practice Location Address
First Line	:	2311 S. CLOSNER
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539
Country	:	US
Telephone Number	:	956-387-0388
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAIDA DURAN
Credential	:
Telephone Number	:	956-387-0388

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	08/22/2020

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Directions to “MAIDA DURAN ” Practice Location

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