Provider Demographics
NPI:1770667404
Name:DORY C MARQUEZ
Entity Type:Organization
Organization Name:DORY C MARQUEZ
Other - Org Name:SANTA MARIA HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DORY
Authorized Official - Middle Name:CLAUDIA
Authorized Official - Last Name:MARQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-631-3860
Mailing Address - Street 1:2537 YUMA AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-7818
Mailing Address - Country:US
Mailing Address - Phone:956-631-3860
Mailing Address - Fax:956-631-3186
Practice Address - Street 1:2537 YUMA AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-7818
Practice Address - Country:US
Practice Address - Phone:956-631-3860
Practice Address - Fax:956-631-3186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010113251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1810053-01Medicaid
TX1810053-01Medicaid