Raices Provider Services, LLC

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Legal business name

RAICES PROVIDER SERVICES, LLC

Practice address

120 Amy Dr
San Juan, TX 78589-3700

Phone

(956) 402-1603

NPI assigned

Feb 8, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Corina Salazar

Title

Owner

Phone

(956) 402-1603

Specialties & licenses 1

Addresses

Other names 1

• Raices Provider Services, LLC Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581120000000",
    "number": "1013549922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 949",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785890949",
            "telephone_number": "956-402-1603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 AMY DR",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785893700",
            "telephone_number": "956-402-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAICES PROVIDER SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-08",
        "last_updated": "2020-02-08",
        "certification_date": "2020-02-08",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "CORINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-402-1603"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Raices Provider Services, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Vittorio T Puente, PH.D.
• Daniela Pulido Salinas
• Bridget Nicole Quevedo, DMD
• Ana Lisa Quintero, MSN, APRN, FNP-BC
• R.T. Nelson, S.E. Nelson, C.L. Lofton Dba Rainbow Adult Day Care
• Rainbow Adult Day Care Inc.
• Ralph Munoz Dba Mi Familia Adc
• Lorrie Ramirez, LPC
• Clotilde Ramon, SLP
• Praveen A Reddy, PA

• Personal Care Attendant in San Juan, TX
• Providers in San Juan, TX by specialty
• Personal Care Attendant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.