MEDICARE: CHAMPION CARE OF ZAPATA, INC

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	251E00000X	Home Health Agency		TX

General Provider Information

NPI Number	:	1780617696
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAMPION CARE OF ZAPATA, INC

Provider Business Mailing Address
First Line	:	2408 NORTH U.S. HIGHWAY 83
Second Line	:	SUITE 2
City	:	ZAPATA
State	:	TX
Zip	:	78076-0000
Country	:	US
Telephone Number	:	956-765-1111
Fax Number	:	956-765-5084

Provider Business Practice Location Address
First Line	:	2408 NORTH U.S. HIGHWAY 83
Second Line	:	SUITE 2
City	:	ZAPATA
State	:	TX
Zip	:	78076-0000
Country	:	US
Telephone Number	:	956-765-1111
Fax Number	:	956-765-5084

Authorized Official
Title or Position	:	OWNER ADMINISTRATOR
Name	:	VELMA NOEMI BARRERA-DECKER
Credential	:
Telephone Number	:	956-765-1111

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	08/22/2020

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