Provider Demographics
NPI:1881995710
Name:MABORO HEALTHCARE SERVICES INC
Entity type:Organization
Organization Name:MABORO HEALTHCARE SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:F
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-704-6684
Mailing Address - Street 1:1146 MIDTOWN DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-2719
Mailing Address - Country:US
Mailing Address - Phone:979-704-6684
Mailing Address - Fax:979-704-6690
Practice Address - Street 1:1146 MIDTOWN DR
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-2719
Practice Address - Country:US
Practice Address - Phone:979-704-6684
Practice Address - Fax:979-704-6690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747725Medicare PIN