Provider Demographics
NPI:1003960717
Name:EL PARQUE ADULT DAY CARE INC
Entity Type:Organization
Organization Name:EL PARQUE ADULT DAY CARE INC
Other - Org Name:EL PARQUEADULT DAY CARE CENTER ZAPATA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:LYDIA
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-487-7374
Mailing Address - Street 1:801 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-3120
Mailing Address - Country:US
Mailing Address - Phone:956-487-7374
Mailing Address - Fax:956-487-7374
Practice Address - Street 1:1110 N US HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076-3732
Practice Address - Country:US
Practice Address - Phone:956-765-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116788261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX003423Medicaid