Provider Demographics
NPI:1114121043
Name:SOUTH TEXAS PERSONAL CARE SERVICE INC.
Entity Type:Organization
Organization Name:SOUTH TEXAS PERSONAL CARE SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:DIANNE
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-584-7600
Mailing Address - Street 1:1022 E GRIFFIN PKWY
Mailing Address - Street 2:SUITE 106B
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2400
Mailing Address - Country:US
Mailing Address - Phone:956-584-7600
Mailing Address - Fax:956-584-7604
Practice Address - Street 1:1022 E GRIFFIN PKWY
Practice Address - Street 2:SUITE 106B
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2400
Practice Address - Country:US
Practice Address - Phone:956-584-7600
Practice Address - Fax:956-584-7604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009720251T00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider OrganizationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185823501Medicaid