Healthcare Provider Details

I. General information

NPI: 1215465315
Provider Name (Legal Business Name): FREEDOM HOME HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2017
Last Update Date: 06/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4712 HOFFMAN DR
AUSTIN TX
78749-3602
US

IV. Provider business mailing address

4712 HOFFMAN DR
AUSTIN TX
78749-3602
US

V. Phone/Fax

Practice location:
  • Phone: 210-286-5329
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number114393
License Number StateTX

VIII. Authorized Official

Name: MR. JOSE L. PALACIOS JR.
Title or Position: OWNER
Credential: OTR
Phone: 210-286-5329