Provider Demographics
NPI:1265420558
Name:DJ HEALTHCARE SERVICES INC
Entity type:Organization
Organization Name:DJ HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARRAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-845-7722
Mailing Address - Street 1:6633 N MESA ST
Mailing Address - Street 2:#315
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-4427
Mailing Address - Country:US
Mailing Address - Phone:915-845-7722
Mailing Address - Fax:915-845-7723
Practice Address - Street 1:6633 N MESA ST
Practice Address - Street 2:#315
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4427
Practice Address - Country:US
Practice Address - Phone:915-845-7722
Practice Address - Fax:915-845-7723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002397163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677543Medicare ID - Type Unspecified