Healthcare Provider Details

I. General information

NPI: 1346315009
Provider Name (Legal Business Name): OUTREACH HEALTH COMMUNITY CARE SERVICES, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 02/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 WEST RENNER PARKWAY
RICHARDSON TX
75080
US

IV. Provider business mailing address

505 E HUNTLAND DR SUITE 520
AUSTIN TX
78752-3717
US

V. Phone/Fax

Practice location:
  • Phone: 512-692-7834
  • Fax: 512-973-8005
Mailing address:
  • Phone: 512-692-7810
  • Fax: 512-973-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License NumberPP0130
License Number StateTX

VIII. Authorized Official

Name: MS. JULIE LORRAINE RYON
Title or Position: DIRECTOR OF ADMINISTRATIVE AND SUPP
Credential:
Phone: 512-692-7834