Provider Demographics
NPI:1902816788
Name:P.A.C.E. HEALTH CARE, INC.
Entity Type:Organization
Organization Name:P.A.C.E. HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:THELMA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAVAZOS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-447-8886
Mailing Address - Street 1:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-0655
Mailing Address - Country:US
Mailing Address - Phone:956-447-8886
Mailing Address - Fax:956-447-2032
Practice Address - Street 1:1001 RONE DR
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-4263
Practice Address - Country:US
Practice Address - Phone:956-447-8886
Practice Address - Fax:956-447-2032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007813251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX024186101Medicaid
TX000017900Medicaid
TX001000924Medicaid
TX000017900Medicaid
TXCL8621Medicare PIN