Provider Demographics
NPI: | 1093957623 |
---|---|
Name: | M-PRO ENTERPRISES, LLC |
Entity type: | Organization |
Organization Name: | M-PRO ENTERPRISES, LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/MANAGER |
Authorized Official - Prefix: | MISS |
Authorized Official - First Name: | YESENIA |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | GOMEZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 956-664-1153 |
Mailing Address - Street 1: | 2711 S JACKSON RD |
Mailing Address - Street 2: | |
Mailing Address - City: | PHARR |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78577-4794 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 956-664-1153 |
Mailing Address - Fax: | 956-223-4462 |
Practice Address - Street 1: | 2711 S JACKSON RD |
Practice Address - Street 2: | |
Practice Address - City: | PHARR |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78577-4794 |
Practice Address - Country: | US |
Practice Address - Phone: | 956-664-1153 |
Practice Address - Fax: | 956-223-4462 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-03-27 |
Last Update Date: | 2019-10-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care |
No | 311Z00000X | Nursing & Custodial Care Facilities | Custodial Care Facility |