Provider Demographics
NPI:1154640340
Name:FERNANDEZ GONZALEZ ASOCIADOS, LLC
Entity Type:Organization
Organization Name:FERNANDEZ GONZALEZ ASOCIADOS, LLC
Other - Org Name:VALLE FELIZ ADULT DAY CARE II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEOBARDO
Authorized Official - Middle Name:L
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-519-9713
Mailing Address - Street 1:1108 E KIKA DE LA GARZA ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-4256
Mailing Address - Country:US
Mailing Address - Phone:956-519-9713
Mailing Address - Fax:956-519-9783
Practice Address - Street 1:1108 E KIKA DE LA GARZA ST
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-4256
Practice Address - Country:US
Practice Address - Phone:956-519-9713
Practice Address - Fax:956-519-9783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102933261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care