Healthcare Provider Details

I. General information

NPI: 1467047514
Provider Name (Legal Business Name): SBP HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4203 WOODCOCK DR STE 206
SAN ANTONIO TX
78228-1339
US

IV. Provider business mailing address

4203 WOODCOCK DR STE 206
SAN ANTONIO TX
78228-1339
US

V. Phone/Fax

Practice location:
  • Phone: 210-457-9039
  • Fax:
Mailing address:
  • Phone: 210-457-9039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SHIYAR B POYRAZ
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 210-457-9039