Provider Demographics
NPI:1942066840
Name:HESLES PROVIDER AGENCY LLC
Entity Type:Organization
Organization Name:HESLES PROVIDER AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:HESLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-968-4942
Mailing Address - Street 1:1336 PATRICIO CIR
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-3854
Mailing Address - Country:US
Mailing Address - Phone:830-968-4942
Mailing Address - Fax:
Practice Address - Street 1:1336 PATRICIO CIR
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-3854
Practice Address - Country:US
Practice Address - Phone:830-968-4942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty