Provider Demographics
NPI:1356555908
Name:UNZUETA, MARIA DOLORES (FOSTER PROVIDER)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DOLORES
Last Name:UNZUETA
Suffix:
Gender:F
Credentials:FOSTER PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 PIEDRA ROJA ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-4340
Mailing Address - Country:US
Mailing Address - Phone:915-855-1054
Mailing Address - Fax:
Practice Address - Street 1:1809 PIEDRA ROJA ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-4340
Practice Address - Country:US
Practice Address - Phone:915-855-1054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility