Healthcare Provider Details

I. General information

NPI: 1841405677
Provider Name (Legal Business Name): CENTRAL TEXAS CAREGIVERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12416 HYMEADOW DR STE 202
AUSTIN TX
78750-2283
US

IV. Provider business mailing address

12416 HYMEADOW DR, SUITE 202
AUSTIN TX
78750
US

V. Phone/Fax

Practice location:
  • Phone: 512-917-2058
  • Fax: 512-331-7995
Mailing address:
  • Phone: 512-917-2058
  • Fax: 512-331-7995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number008795
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number008795
License Number StateTX

VIII. Authorized Official

Name: MRS. SEANA M WHEELER
Title or Position: ADMINISTRATOR
Credential:
Phone: 512-917-2058