Provider Demographics
NPI:1700172996
Name:ROCHA PRIMARY CARE, LLC
Entity Type:Organization
Organization Name:ROCHA PRIMARY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROCHA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:956-286-3333
Mailing Address - Street 1:803 MCCLELLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-6277
Mailing Address - Country:US
Mailing Address - Phone:956-286-3333
Mailing Address - Fax:
Practice Address - Street 1:803 MCCLELLAND AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-6277
Practice Address - Country:US
Practice Address - Phone:956-286-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-26
Last Update Date:2011-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care