Provider Demographics
NPI:1427634682
Name:DONA MARI'S RGV PRIMARY HOME CARE, LLC.
Entity type:Organization
Organization Name:DONA MARI'S RGV PRIMARY HOME CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VANEZA
Authorized Official - Middle Name:
Authorized Official - Last Name:OCHOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-961-5755
Mailing Address - Street 1:2602 GARDENIA DR
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-3854
Mailing Address - Country:US
Mailing Address - Phone:956-310-8275
Mailing Address - Fax:956-513-0429
Practice Address - Street 1:2602 GARDENIA DR
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-3854
Practice Address - Country:US
Practice Address - Phone:956-961-5755
Practice Address - Fax:956-513-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1427634682Medicaid