MEDICARE: LINDOS MOMENTOS

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	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1730480385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDOS MOMENTOS

Provider Business Mailing Address
First Line	:	2514 BUDDY OWENS AVE
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-5464
Country	:	US
Telephone Number	:	956-878-8869
Fax Number	:

Provider Business Practice Location Address
First Line	:	2514 BUDDY OWENS AVE
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-5464
Country	:	US
Telephone Number	:	956-878-8869
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	BERTHA ALICIA VILLAGOMEZ
Credential	:
Telephone Number	:	956-878-8860

Provider Enumeration Date	:	11/13/2010
Last Update Date	:	11/13/2010

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Directions to “LINDOS MOMENTOS ” Practice Location

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