Healthcare Provider Details

I. General information

NPI: 1396672655
Provider Name (Legal Business Name): HIGH PLAINS HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4237 ROGERS CREEK CT
DULUTH GA
30096-2103
US

IV. Provider business mailing address

5900 BALCONES DR STE 100
AUSTIN TX
78731-4298
US

V. Phone/Fax

Practice location:
  • Phone: 432-315-4720
  • Fax:
Mailing address:
  • Phone: 432-315-4720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: ANTONIO BRWON
Title or Position: CEO
Credential:
Phone: 432-315-4720