Provider Demographics
NPI:1083012256
Name:PRO HEART HEALTHCARE, LLC.
Entity Type:Organization
Organization Name:PRO HEART HEALTHCARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PESINA- GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:361-933-5062
Mailing Address - Street 1:PO BOX 260058
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78426-0058
Mailing Address - Country:US
Mailing Address - Phone:361-933-5062
Mailing Address - Fax:361-933-5059
Practice Address - Street 1:13701 NORTHWEST BLVD
Practice Address - Street 2:SUITE D-1
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-5114
Practice Address - Country:US
Practice Address - Phone:361-933-5062
Practice Address - Fax:361-933-5059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health