Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2018-08-29
- Last updated
- 2018-08-29
Specialties
Licenses
- License TX
- 149535
Location
- Practice location
- 730 COUNTY ROAD 664
- City
- DEVINE TX
- Postal code
- 780164685
- Phone
- 210-977-9178
Organization contact
- Name
- VIRGINIA MINDIETA
- Title
- President
- Phone
- 5126579262
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
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