1306809413 NPI number — SUNGLO HOME HEALTH SERVICES, INC.

Table of content: (NPI 1306809413)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306809413 NPI number — SUNGLO HOME HEALTH SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUNGLO HOME HEALTH SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306809413
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2026 E TYLER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARLINGEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78550-7466
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-423-6100
Provider Business Mailing Address Fax Number:
956-365-3387

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
802 E TYLER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-7466
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-423-6100
Provider Business Practice Location Address Fax Number:
956-365-3387
Provider Enumeration Date:
04/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MENDOZA
Authorized Official First Name:
LAURA
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
956-423-6100

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  002231 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA0600X , with the licence number: 60K8255 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 002231 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 001002371 . This is a "MDCP WAIVER PROGRAM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001013703 . This is a "DAHS WAIVER PROGRAM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001012023 . This is a "PHC WAIVER PROGRAM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001013702 . This is a "DAHS WAIVER PROGRAM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001013706 . This is a "DAHS WAIVER PROGRAM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001013707 . This is a "DAHS WAIVER PROGRAM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001013704 . This is a "DAHS WAIVER PROGRAM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001013705 . This is a "DHAS WAIVER PROGRAM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 000651000 . This is a "CBA WAIVER PROGRAM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001013701 . This is a "DAHS WAIVER PROGRAM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 024556501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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