Provider Demographics
NPI:1447327135
Name:EL ORO DEL PUEBLO SERVICES, INC.
Entity type:Organization
Organization Name:EL ORO DEL PUEBLO SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MSW AP
Authorized Official - Phone:956-968-1271
Mailing Address - Street 1:PO BOX 267
Mailing Address - Street 2:2015 E UNIVERSITY DR
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-0267
Mailing Address - Country:US
Mailing Address - Phone:956-968-1271
Mailing Address - Fax:
Practice Address - Street 1:2015 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3857
Practice Address - Country:US
Practice Address - Phone:956-968-1271
Practice Address - Fax:956-973-9700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115767261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care