Provider Demographics
NPI:1053926972
Name:EL ALFARERO Y YO PHC, LLC
Entity type:Organization
Organization Name:EL ALFARERO Y YO PHC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:GUADALUPE
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-272-1965
Mailing Address - Street 1:PO BOX 487
Mailing Address - Street 2:
Mailing Address - City:EDCOUCH
Mailing Address - State:TX
Mailing Address - Zip Code:78538-0487
Mailing Address - Country:US
Mailing Address - Phone:956-272-1965
Mailing Address - Fax:956-517-1498
Practice Address - Street 1:209 E A GUTIERREZ
Practice Address - Street 2:
Practice Address - City:EDCOUCH
Practice Address - State:TX
Practice Address - Zip Code:78538-7853
Practice Address - Country:US
Practice Address - Phone:956-272-1965
Practice Address - Fax:956-517-1498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty