Black Casino

NPI 1093956831 - Clinic/Center - 261QA0600X

NPI Details
NPI 1093956831
Enumeration Date 03/06/2009
Last Updated 03/06/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name LUIS MACARIO LUIS
Position DIRECTOR
Phone (956) 337-9314
Fax
Practice Location
302 WASHINGTON ST
SUITE B
LAREDO TX, 78040-4544, US
Phone (956) 337-9314
Fax
Business Location
614 BERKLEY RD
LAREDO TX, 78045-2416, US
Phone
Fax
Toxanomy
Taxonomy Code 261QA0600X
License State
License Number
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According to our database, Black Casino NPI is 1093956831, taxonomy code is 261QA0600X Black Casino physically located at 302 Washington St, Laredo TX, 78040-4544. NPI Number 1033115704 has the healthcare provider type.

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1093956831 NPI number is provided on an as is basis without warranty of any kind. 1093956831 is maintained by the National Plan & Provider Enumeration System. The contents of Black Casino are for informational purposes only.