Individual
SELENE ROJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 N. FABENS STREET, FABENS, TX 79839
(915) 694-2639
Mailing address
PO BOX 4013, FABENS, TX 79838-4013
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
882161836
—
TX
Enumeration date
06/17/2022
Last updated
06/18/2022
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