Provider Demographics
NPI:1649200353
Name:DOS FRONTERAS, LLC
Entity Type:Organization
Organization Name:DOS FRONTERAS, LLC
Other - Org Name:MAVERICK HOSPICE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-773-4009
Mailing Address - Street 1:2483 2ND ST STE D
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-4391
Mailing Address - Country:US
Mailing Address - Phone:830-773-4009
Mailing Address - Fax:830-773-4078
Practice Address - Street 1:2483 2ND ST STE D
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-4391
Practice Address - Country:US
Practice Address - Phone:830-773-4009
Practice Address - Fax:830-773-4078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based