Provider Demographics
NPI:1134288038
Name:ROMELIA VIGIL DBA STRAWBERRY PATCH ADC
Entity Type:Organization
Organization Name:ROMELIA VIGIL DBA STRAWBERRY PATCH ADC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VIGIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-682-4054
Mailing Address - Street 1:1605 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2213
Mailing Address - Country:US
Mailing Address - Phone:956-682-4054
Mailing Address - Fax:956-994-0601
Practice Address - Street 1:1605 N 6TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2213
Practice Address - Country:US
Practice Address - Phone:956-682-4054
Practice Address - Fax:956-994-0601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care