Provider Demographics
NPI:1205273307
Name:DCMJ ENTERPRISES LLC
Entity type:Organization
Organization Name:DCMJ ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:GRESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-844-0574
Mailing Address - Street 1:1614 N TACUBAYA ST
Mailing Address - Street 2:
Mailing Address - City:ROMA
Mailing Address - State:TX
Mailing Address - Zip Code:78584-5639
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1867 N HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:ROMA
Practice Address - State:TX
Practice Address - Zip Code:78584-8549
Practice Address - Country:US
Practice Address - Phone:956-849-1302
Practice Address - Fax:956-849-1286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care