Provider Demographics
NPI:1225211691
Name:DELEON PRIMARY HOME CARE, INC.
Entity Type:Organization
Organization Name:DELEON PRIMARY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GUADALUPE
Authorized Official - Middle Name:
Authorized Official - Last Name:DELEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-727-7775
Mailing Address - Street 1:1519 WASHINGTON ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-4412
Mailing Address - Country:US
Mailing Address - Phone:956-727-7775
Mailing Address - Fax:956-727-7778
Practice Address - Street 1:1519 WASHINGTON ST
Practice Address - Street 2:SUITE 1
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-4412
Practice Address - Country:US
Practice Address - Phone:956-727-7775
Practice Address - Fax:956-727-7778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-08
Last Update Date:2007-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010913251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health