Provider Demographics
NPI:1114106226
Name:EXCELLENT NURSING CARE - PROVIDERS
Entity Type:Organization
Organization Name:EXCELLENT NURSING CARE - PROVIDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMERO
Authorized Official - Suffix:SR
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:956-725-2786
Mailing Address - Street 1:8514 CROWNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-2085
Mailing Address - Country:US
Mailing Address - Phone:956-725-2786
Mailing Address - Fax:956-723-9833
Practice Address - Street 1:8514 CROWNWOOD DR
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-2085
Practice Address - Country:US
Practice Address - Phone:956-725-2786
Practice Address - Fax:956-723-9833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0100703747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty