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Individual

IMELDA RODRIGUEZ TABARES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
29 BROKEN ARROW STREET, BRACKETTVILLE, TX 78832
(210) 420-3567
Mailing address
PO BOX 232, BRACKETTVILLE, TX 78832-0232
(210) 420-3567

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
09918803
TX

Other

Enumeration date
10/06/2023
Last updated
10/06/2023
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