Provider Demographics
NPI:1598805756
Name:TOMASITA C. MENDIOLA
Entity Type:Organization
Organization Name:TOMASITA C. MENDIOLA
Other - Org Name:ALEGRO'S ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TOMMIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MENDIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-968-6005
Mailing Address - Street 1:320 E HUISACHE ST
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-4828
Mailing Address - Country:US
Mailing Address - Phone:956-968-6005
Mailing Address - Fax:956-968-6122
Practice Address - Street 1:320 E HUISACHE ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-4828
Practice Address - Country:US
Practice Address - Phone:956-968-6005
Practice Address - Fax:956-968-6122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118067261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX118067Medicaid