NPIMap

Organization Active NPI

Maverick Adult Day Care, LLC

Doing business as Eagle Pass Therapy Services

  • Physical Therapist
  • Eagle Pass, TX
National Provider Identifier
1386691095
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1164678 Issued in TX
Legal business name
MAVERICK ADULT DAY CARE, LLC
Doing business as
Eagle Pass Therapy Services
Practice address
2499 N Veterans Blvd
Suite E
Eagle Pass, TX 78852-6644
Phone
(830) 758-0366
Fax
(830) 758-0365
NPI assigned
May 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Yanesia Vela
Title
Office Manager
Phone
(830) 758-0366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1164678 TX Primary

Addresses

Primary practice location

2499 N Veterans Blvd
Suite E
Eagle Pass, TX 78852-6644

Mailing address

2499 N Veterans Blvd
Suite E
Eagle Pass, TX 78852-6644
Phone (830) 758-0366

Other identifiers 2

IdentifierTypeStateIssuer
0069NFOtherTXCLINIC-BCBS
8T6180OtherTXPROVIDER-BCBS

Other names 1

  • Eagle Pass Therapy Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eagle Pass Therapy Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386691095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2499 N VETERANS BLVD",
            "address_2": "SUITE E",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788526644",
            "telephone_number": "830-758-0366",
            "fax_number": "830-758-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2499 N VETERANS BLVD",
            "address_2": "SUITE E",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788526644",
            "telephone_number": "830-758-0366",
            "fax_number": "830-758-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVERICK ADULT DAY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VELA",
        "authorized_official_first_name": "YANESIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "830-758-0366",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1164678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC-BCBS",
            "identifier": "0069NF",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER-BCBS",
            "identifier": "8T6180",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Pass Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagle Pass, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.