Provider Demographics
NPI:1720733546
Name:TEXAS COVID TESTING SITE LLC
Entity Type:Organization
Organization Name:TEXAS COVID TESTING SITE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:E
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:956-466-1938
Mailing Address - Street 1:1474 W PRICE RD STE 7124
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8687
Mailing Address - Country:US
Mailing Address - Phone:956-466-1938
Mailing Address - Fax:
Practice Address - Street 1:1474 W PRICE RD STE 7124
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8687
Practice Address - Country:US
Practice Address - Phone:956-466-1938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-21
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty