Provider Demographics
NPI:1477153682
Name:TORRES, JUAN MIGUEL
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:MIGUEL
Last Name:TORRES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6724 GEORGIA PNE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3018
Mailing Address - Country:US
Mailing Address - Phone:956-459-7133
Mailing Address - Fax:956-306-6716
Practice Address - Street 1:274 KINGS HWY STE 126-A
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-5698
Practice Address - Country:US
Practice Address - Phone:956-459-7133
Practice Address - Fax:956-306-6716
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0196933747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant