Healthcare Provider Details

I. General information

NPI: 1699714006
Provider Name (Legal Business Name): WELL-CARE HOME HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10103 FONDREN RD SUITE: 230
HOUSTON TX
77096-4556
US

IV. Provider business mailing address

PO BOX 1230
HARLINGEN TX
78551-1230
US

V. Phone/Fax

Practice location:
  • Phone: 281-988-5304
  • Fax: 281-988-5309
Mailing address:
  • Phone: 956-423-1197
  • Fax: 956-440-1837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number010303
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number010303
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number010303
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number010303
License Number StateTX

VIII. Authorized Official

Name: MR. RODNEY MESQUIAS
Title or Position: OWNER
Credential: RN
Phone: 956-423-1197