Provider Demographics
NPI:1104180066
Name:UNIDOS PRIMARY HEALTH CARE LLC
Entity Type:Organization
Organization Name:UNIDOS PRIMARY HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMUDIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-605-0550
Mailing Address - Street 1:1612 E GRIFFIN PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3180
Mailing Address - Country:US
Mailing Address - Phone:956-655-0550
Mailing Address - Fax:
Practice Address - Street 1:1612 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3180
Practice Address - Country:US
Practice Address - Phone:956-655-0550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-26
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health