MEDICARE: GARZA AND GARZA ENT.INC.DBA EL CENTRO ADULT DAY CARE

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	305R00000X	Preferred Provider Organization	001524	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001524	OTHER	TX	FACILITY NUMBER

General Provider Information

NPI Number	:	1962691881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARZA AND GARZA ENT.INC.DBA EL CENTRO ADULT DAY CARE

Provider Business Mailing Address
First Line	:	108 E MAIN ST
Second Line	:
City	:	RIO GRANDE CITY
State	:	TX
Zip	:	78582-4443
Country	:	US
Telephone Number	:	956-716-8909
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 E MAIN ST
Second Line	:
City	:	RIO GRANDE CITY
State	:	TX
Zip	:	78582-4443
Country	:	US
Telephone Number	:	956-716-8909
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. ROBERT DUANE GUERRA
Credential	:
Telephone Number	:	956-716-8909

Provider Enumeration Date	:	10/16/2007
Last Update Date	:	10/16/2007

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