Provider Demographics
NPI:1851943575
Name:DE FE PROVIDER HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:DE FE PROVIDER HEALTH SERVICES LLC
Other - Org Name:DE FE PROVIDER HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-520-8127
Mailing Address - Street 1:3109 CACTUS DR
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-4958
Mailing Address - Country:US
Mailing Address - Phone:956-520-8127
Mailing Address - Fax:956-520-8137
Practice Address - Street 1:3109 CACTUS DR
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78599-4958
Practice Address - Country:US
Practice Address - Phone:956-520-8127
Practice Address - Fax:956-520-8137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No291U00000XLaboratoriesClinical Medical Laboratory