Individual
MS. ADELI BONITA YBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2714 OLD DALLAS RD, WACO, TX 76705-1771
(254) 799-1099
(254) 946-0900
Mailing address
PO BOX 154846, WACO, TX 76715-4846
(254) 338-0518
(254) 946-0900
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
111371
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001012112
—
TX
Enumeration date
10/17/2007
Last updated
10/17/2007
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