Provider Demographics
NPI:1285395681
Name:28TH STATE CONSTRUCTION LLC
Entity type:Organization
Organization Name:28TH STATE CONSTRUCTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MINJARES - SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-270-0842
Mailing Address - Street 1:6603 HADDONFIELD ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-4731
Mailing Address - Country:US
Mailing Address - Phone:956-270-0842
Mailing Address - Fax:
Practice Address - Street 1:6603 HADDONFIELD ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542-4731
Practice Address - Country:US
Practice Address - Phone:956-270-0842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-07
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies