Provider Demographics
NPI:1538605621
Name:MATERNITY CARE CENTER
Entity type:Organization
Organization Name:MATERNITY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:RAMON
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:830-775-9947
Mailing Address - Street 1:1308 LAS VACAS ST
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840
Mailing Address - Country:US
Mailing Address - Phone:830-775-9947
Mailing Address - Fax:830-768-3810
Practice Address - Street 1:1308 LAS VACAS ST
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840
Practice Address - Country:US
Practice Address - Phone:830-775-9947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96032367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty