Provider Demographics
NPI:1912348442
Name:GREAT AMERICAN INSULATION
Entity Type:Organization
Organization Name:GREAT AMERICAN INSULATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-239-1315
Mailing Address - Street 1:2407 BROCK ST
Mailing Address - Street 2:SUITE 'C'
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3361
Mailing Address - Country:US
Mailing Address - Phone:956-585-8730
Mailing Address - Fax:956-271-4376
Practice Address - Street 1:2407 BROCK ST
Practice Address - Street 2:SUITE 'C'
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3361
Practice Address - Country:US
Practice Address - Phone:956-585-8730
Practice Address - Fax:956-271-4376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty