Provider Demographics
NPI:1184902819
Name:IBERMARK, LLC
Entity type:Organization
Organization Name:IBERMARK, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GONZALO
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL VAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-482-9686
Mailing Address - Street 1:26119 I-45
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1961
Mailing Address - Country:US
Mailing Address - Phone:832-482-9686
Mailing Address - Fax:
Practice Address - Street 1:26119 I-45
Practice Address - Street 2:SUITE 205
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-1961
Practice Address - Country:US
Practice Address - Phone:832-482-9686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health