Provider Demographics
NPI:1609087758
Name:PRISCILLA VASQUEZ & JOE A. FLORES
Entity Type:Organization
Organization Name:PRISCILLA VASQUEZ & JOE A. FLORES
Other - Org Name:VASQUEZ-FLORES HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:VASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BC
Authorized Official - Phone:361-881-9922
Mailing Address - Street 1:PO BOX 8734
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78468-8734
Mailing Address - Country:US
Mailing Address - Phone:361-881-9922
Mailing Address - Fax:361-881-9928
Practice Address - Street 1:3034 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2601
Practice Address - Country:US
Practice Address - Phone:361-881-9922
Practice Address - Fax:361-881-9928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007816251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS50028572OtherLONG TERM CARE PROVIDER
TX007816OtherHCSSA LICENSE