Healthcare Provider Details

I. General information

NPI: 1649347162
Provider Name (Legal Business Name): NATIONAL MEDICAL HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CROWN RIDGE BLVD STE. F
EAGLE PASS TX
78852-3218
US

IV. Provider business mailing address

121 INTERPARK BLVD STE 105
SAN ANTONIO TX
78216-1844
US

V. Phone/Fax

Practice location:
  • Phone: 830-757-0900
  • Fax: 830-757-0908
Mailing address:
  • Phone: 210-822-0475
  • Fax: 210-822-0485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number010971
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number010971
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number010971
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number010971
License Number StateTX

VIII. Authorized Official

Name: STEPHEN WALLACE
Title or Position: CEO
Credential:
Phone: 210-822-0475