Organization
EL DORADO TEXAS COMMUNITY SERVICES CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRAMESH P SHARMA (DIRECTOR OF ADMINISTRATION)
(661) 313-5503
Entity
Organization
Contact information
Practice address
954 E MADISON ST, BROWNSVILLE, TX 78520-5950
(956) 550-9970
(956) 982-4294
Mailing address
954 E MADISON ST, BROWNSVILLE, TX 78520-5950
(956) 550-9970
(956) 982-4294
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
00533W
TX
261QM2800X
Methadone Clinic
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000057
STATE OTP LICENSE
TX
05
—
175582901
—
TX
Enumeration date
01/11/2007
Last updated
08/30/2022
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