Provider Demographics
NPI:1245604339
Name:INFINITE PHC,LLC
Entity Type:Organization
Organization Name:INFINITE PHC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SELINA
Authorized Official - Middle Name:SOLIZ
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:361-701-1137
Mailing Address - Street 1:301 N KING ST STE 106
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-4761
Mailing Address - Country:US
Mailing Address - Phone:361-701-1137
Mailing Address - Fax:361-453-7483
Practice Address - Street 1:301 N KING ST STE 106
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-4761
Practice Address - Country:US
Practice Address - Phone:361-701-1137
Practice Address - Fax:361-453-7483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-30
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty