Provider Demographics
NPI:1073284733
Name:EVERCARE HEALTHCARE, INC.
Entity Type:Organization
Organization Name:EVERCARE HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:
Authorized Official - Last Name:DUQUE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-212-6198
Mailing Address - Street 1:1713 W GRIFFIN PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-7306
Mailing Address - Country:US
Mailing Address - Phone:956-212-6198
Mailing Address - Fax:956-391-2345
Practice Address - Street 1:1713 W GRIFFIN PKWY STE B
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-7306
Practice Address - Country:US
Practice Address - Phone:956-212-6198
Practice Address - Fax:956-391-2345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00000Medicaid