Organization
ESTRELLA PROVIDER SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMIRO G RODRIGUEZ (ALTERNATE ADMINISTRATOR)
(956) 723-1234
Entity
Organization
Contact information
Practice address
107 CALLE DEL NORTE #17 A, LAREDO, TX 78041
(956) 723-1234
(866) 239-0666
Mailing address
107 CALLE DEL NORTE #17 A, LAREDO, TX 78041
(956) 723-1234
(866) 239-0666
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
261QP2300X
Primary Care Clinic/Center
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001025795
—
TX
05
—
001028438
—
TX
Enumeration date
08/19/2011
Last updated
01/14/2021
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