Provider Demographics
NPI:1851413363
Name:FIRST CHOICE PROVIDER SERVICES, INC.
Entity Type:Organization
Organization Name:FIRST CHOICE PROVIDER SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:DR
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:JULIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:956-631-1388
Mailing Address - Street 1:713 E ESPERANZA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-1447
Mailing Address - Country:US
Mailing Address - Phone:956-631-1388
Mailing Address - Fax:956-631-1397
Practice Address - Street 1:713 E ESPERANZA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-1447
Practice Address - Country:US
Practice Address - Phone:956-631-1388
Practice Address - Fax:956-631-1397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007998251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001003093OtherPHC FC VENDOR NUMBER
TX001012911OtherCBA HCSS VENDOR NUMBER
TX007998Medicaid