Provider Demographics
NPI:1689071615
Name:PROCARE HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:PROCARE HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KEDEESH
Authorized Official - Middle Name:N
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-907-2976
Mailing Address - Street 1:1600 E 30TH ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574-1788
Mailing Address - Country:US
Mailing Address - Phone:956-225-9985
Mailing Address - Fax:956-205-2222
Practice Address - Street 1:1600 E 30TH ST
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78574-1788
Practice Address - Country:US
Practice Address - Phone:956-225-9985
Practice Address - Fax:956-205-2222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service