Provider Demographics
NPI:1659579357
Name:TENDER TEXAS HEART, L.L.C.
Entity Type:Organization
Organization Name:TENDER TEXAS HEART, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:EDITH
Authorized Official - Last Name:BALDERAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-793-0181
Mailing Address - Street 1:3401 AUBURN AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6434
Mailing Address - Country:US
Mailing Address - Phone:956-793-0181
Mailing Address - Fax:
Practice Address - Street 1:3401 AUBURN AVE
Practice Address - Street 2:SUITE E
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6434
Practice Address - Country:US
Practice Address - Phone:956-793-0181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3280463-01Medicaid
TX3280463-02Medicaid
TX743139OtherMEDICARE PTAN