Provider Demographics
NPI:1639214992
Name:OSCAR V GONZALEZ EL VAQUERO ADULT DAYCARE
Entity Type:Organization
Organization Name:OSCAR V GONZALEZ EL VAQUERO ADULT DAYCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:VICENTE
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-585-6074
Mailing Address - Street 1:7209 W EXPRESSWAY 83
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-9685
Mailing Address - Country:US
Mailing Address - Phone:956-585-6074
Mailing Address - Fax:956-580-3143
Practice Address - Street 1:7209 W EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-9685
Practice Address - Country:US
Practice Address - Phone:956-585-6074
Practice Address - Fax:956-580-3143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118456261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care