Provider Demographics
NPI:1558533547
Name:EN AQUELLOS TIEMPOS ADC INC
Entity Type:Organization
Organization Name:EN AQUELLOS TIEMPOS ADC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-802-2228
Mailing Address - Street 1:1703 W OWASSA RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-7047
Mailing Address - Country:US
Mailing Address - Phone:956-702-4685
Mailing Address - Fax:
Practice Address - Street 1:1209 W. FM 495
Practice Address - Street 2:SUITE 1
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589
Practice Address - Country:US
Practice Address - Phone:956-702-4685
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care