Provider Demographics
NPI:1205162815
Name:J G BURCIAGA ENTERPRISES, INC.
Entity type:Organization
Organization Name:J G BURCIAGA ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/REGISTERED AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:GABRIEL
Authorized Official - Last Name:BURCIAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-605-9887
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-0009
Mailing Address - Country:US
Mailing Address - Phone:956-223-2575
Mailing Address - Fax:956-783-1836
Practice Address - Street 1:216 E. EXPRESSWAY 83
Practice Address - Street 2:SUITE K OFFICE A
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577
Practice Address - Country:US
Practice Address - Phone:956-223-2575
Practice Address - Fax:956-783-1836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance