NPIMap

Organization Active NPI

Dos Fronteras, LLC

Doing business as Maverick Hospice Care

  • Community Based Hospice Care Agency
  • Eagle Pass, TX
National Provider Identifier
1649200353
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
DOS FRONTERAS, LLC
Doing business as
Maverick Hospice Care
Practice address
2483 2ND St Ste D
Eagle Pass, TX 78852-4391
Phone
(830) 773-4009
Fax
(830) 773-4078
NPI assigned
Jul 5, 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
Jose Hernandez
Title
Administrator
Phone
(830) 773-4009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

2483 2ND St Ste D
Eagle Pass, TX 78852-4391

Mailing address

2483 2ND St Ste D
Eagle Pass, TX 78852-4391
Phone (830) 773-4009

Other names 1

  • Maverick Hospice Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060705000120 TX Part A Provider - Hospice 7214949585 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Eagle Pass, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649200353. Details of each certification follow.

Hospice certification: CCN 671598

Legal name
DOS FRONTERAS, LLC
Doing business as
MAVERICK HOSPICE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 30, 2008
Last certification
Dec 5, 2019
Ownership / control type
Proprietary - Other
Organization structure
LLCProprietary
Incorporated
Apr 18, 2006 in TX
Enrollment address
2822 N Veterans Blvd
Ste B
Eagle Pass, TX 78852-4391

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospice

Medicare Care Compare
Listed as
Maverick Hospice CareCCN 671598 · All quality measures
Ownership
Other
Certified
May 30, 2008
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

2298 N Veterans Blvd
Ste 3
Eagle Pass, TX 78852
Phone (830) 757-1362

2483 2nd St
Ste D
Eagle Pass, TX 78852
Phone (830) 757-9700

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Victor Alonzo Gonzalez Individual Corporate Director Mar 3, 2006
W-2 Managing Employee Mar 3, 2006
Alejandra Faz Individual W-2 Managing Employee Oct 5, 2009
Jose Hernandez Individual 5% Or Greater Direct Ownership Interest Nov 19, 2019 100%
Corporate Director Mar 3, 2006
W-2 Managing Employee Mar 3, 2006

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649200353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2483 2ND ST STE D",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788524391",
            "telephone_number": "830-773-4009",
            "fax_number": "830-773-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2483 2ND ST STE D",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788524391",
            "telephone_number": "830-773-4009",
            "fax_number": "830-773-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOS FRONTERAS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "830-773-4009"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maverick Hospice Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagle Pass, TX

Sources for this page

Verify at the official NPI Registry.