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NPI Code Detail

MEDICARE: WAGGONER & THOMAS ALL-CARE, INC

MEDICARE: WAGGONER & THOMAS ALL-CARE, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency355553TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205962388
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAGGONER & THOMAS ALL-CARE, INC
Provider Business Mailing Address
First Line : 4100 E PIEDRAS DR
Second Line : SUITE 205
City : SAN ANTONIO
State : TX
Zip : 78228-1401
Country : US
Telephone Number : 210-745-3940
Fax Number : 210-745-3938
Provider Business Practice Location Address
First Line : 4100 E PIEDRAS DR
Second Line : SUITE 205
City : SAN ANTONIO
State : TX
Zip : 78228-1401
Country : US
Telephone Number : 210-745-3940
Fax Number : 210-745-3938
Authorized Official
Title or Position : DIRECTOR
Name : MS. MONICA E TREVINO
Credential : LMSW
Telephone Number : 210-745-3940
Provider Enumeration Date : 02/26/2007
Last Update Date : 08/22/2020

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1972631844 — MS. MONICA E TREVINO LMSW
Practice Location Address:
4100 E PIEDRAS DR , SUITE 205
SAN ANTONIO, TX
78228-1401
Practice Phone: 210-745-3940
Practice Fax: 210-745-3938

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