Provider Demographics
NPI:1447760400
Name:PANDEVIDA LLC
Entity Type:Organization
Organization Name:PANDEVIDA LLC
Other - Org Name:PAN DE VIDA HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-887-7014
Mailing Address - Street 1:2916 N TAYLOR RD STE 2
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-5409
Mailing Address - Country:US
Mailing Address - Phone:956-887-7014
Mailing Address - Fax:956-887-7015
Practice Address - Street 1:2916 N TAYLOR RD STE 2
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5409
Practice Address - Country:US
Practice Address - Phone:956-887-7014
Practice Address - Fax:956-887-7015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-04
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health