Healthcare Provider Details

I. General information

NPI: 1003229642
Provider Name (Legal Business Name): TRIO HOME HEALTH-RURAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2014
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 CORONA DR SUITE 205 B
CORPUS CHRISTI TX
78411-4324
US

IV. Provider business mailing address

4444 CORONA DR STE 205
CORPUS CHRISTI TX
78411-4325
US

V. Phone/Fax

Practice location:
  • Phone: 361-728-6336
  • Fax:
Mailing address:
  • Phone: 361-881-8787
  • Fax: 361-881-8815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VAN PHAN VILLA
Title or Position: ADMINISTRATOR
Credential:
Phone: 361-881-8787