Provider Demographics
NPI:1831692961
Name:FABIAN SILGUERO
Entity type:Organization
Organization Name:FABIAN SILGUERO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:G
Authorized Official - Last Name:DOMINGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-797-4290
Mailing Address - Street 1:1600 E EXPRESSWAY 83
Mailing Address - Street 2:
Mailing Address - City:LA FERIA
Mailing Address - State:TX
Mailing Address - Zip Code:78559-4742
Mailing Address - Country:US
Mailing Address - Phone:956-797-4290
Mailing Address - Fax:956-797-4287
Practice Address - Street 1:1600 E EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:LA FERIA
Practice Address - State:TX
Practice Address - Zip Code:78559-4742
Practice Address - Country:US
Practice Address - Phone:956-797-4290
Practice Address - Fax:956-797-4287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010809251G00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2207748Medicaid
713410OtherSUPERIOR
20554OtherMOLINA
87726OtherUNITED HEALTH CARE
0111132OtherWELL MED
61101OtherHUMANA
61125OtherTRICARE
74284OtherDRISCOLL
82238OtherALLEGIAN
60054OtherAETNA
84980OtherBCBS
77082OtherCARE IMPROVEMENT PLUS
52192OtherCIGNA HEALTH SPRINGS