Provider Demographics
NPI:1376842377
Name:CATALINA GONZALEZ GARCIA
Entity Type:Organization
Organization Name:CATALINA GONZALEZ GARCIA
Other - Org Name:MIS AMIGOS DE WESLACO ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DBA
Authorized Official - Prefix:
Authorized Official - First Name:CATALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-380-6249
Mailing Address - Street 1:707 ANGELITA DR
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-4324
Mailing Address - Country:US
Mailing Address - Phone:956-968-4018
Mailing Address - Fax:956-968-4787
Practice Address - Street 1:707 ANGELITA DR
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78599-4324
Practice Address - Country:US
Practice Address - Phone:956-968-4018
Practice Address - Fax:956-968-4787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001016883261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1376842377Medicaid
TX1019665Medicaid