Healthcare Provider Details

I. General information

NPI: 1699080242
Provider Name (Legal Business Name): CONVENIENT HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2010
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 MAIN ST SUITE A
BUDA TX
78610-5043
US

IV. Provider business mailing address

1645 MAIN ST SUITE A
BUDA TX
78610-5043
US

V. Phone/Fax

Practice location:
  • Phone: 830-837-6277
  • Fax: 830-632-6424
Mailing address:
  • Phone: 830-837-6277
  • Fax: 830-632-6424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number013734
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number013734
License Number StateTX

VIII. Authorized Official

Name: CASSANDRA ADAMS
Title or Position: ADMINISTRATOR/OWNER
Credential:
Phone: 830-837-6277