Healthcare Provider Details

I. General information

NPI: 1073510574
Provider Name (Legal Business Name): DEPENDACARE OF AUSTIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 09/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5321 INDUSTRIAL OAKS BLVD SUITE # 121
AUSTIN TX
78735-8822
US

IV. Provider business mailing address

5321 INDUSTRIAL OAKS BLVD SUITE # 121
AUSTIN TX
78735-8822
US

V. Phone/Fax

Practice location:
  • Phone: 512-892-0405
  • Fax: 512-892-0431
Mailing address:
  • Phone: 512-892-0405
  • Fax: 512-892-0431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number0071814
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number0071814
License Number StateTX

VIII. Authorized Official

Name: MS. LINDEE L HENDRIX
Title or Position: CEO
Credential:
Phone: 512-944-9916