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Organization
MAVERICK ADULT DAY CARE, LLC
Active
Organization
MAVERICK ADULT DAY CARE, LLC
Active
Other names
Eagle Pass Therapy Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YANESIA VELA (OFFICE MANAGER)
(830) 758-0366
Entity
Organization
Contact information
Practice address
2499 N VETERANS BLVD, SUITE E, EAGLE PASS, TX 78852-6644
(830) 758-0366
(830) 758-0365
Mailing address
2499 N VETERANS BLVD, SUITE E, EAGLE PASS, TX 78852-6644
(830) 758-0366
(830) 758-0365
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1164678
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0069NF
CLINIC-BCBS
TX
01
—
8T6180
PROVIDER-BCBS
TX
Enumeration date
05/28/2006
Last updated
08/22/2020
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