Provider Demographics
NPI:1285701904
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:BLANCE
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 52208
Mailing Address - Street 2:1904 S 10TH ST
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78505-2208
Mailing Address - Country:US
Mailing Address - Phone:956-968-1271
Mailing Address - Fax:956-973-9799
Practice Address - Street 1:1904 S 10TH ST
Practice Address - Street 2:SUITE 1902 1904 1906
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-5404
Practice Address - Country:US
Practice Address - Phone:956-383-7933
Practice Address - Fax:956-383-7018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117622261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care