Healthcare Provider Details

I. General information

NPI: 1578857249
Provider Name (Legal Business Name): BEXAR HEALTHCARE CONSORTIUM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2011
Last Update Date: 05/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5202 TEXANA DR SUITE 1414
SAN ANTONIO TX
78249-3772
US

IV. Provider business mailing address

5202 TEXANA DR SUITE 1414
SAN ANTONIO TX
78249-3772
US

V. Phone/Fax

Practice location:
  • Phone: 210-861-3541
  • Fax:
Mailing address:
  • Phone: 210-861-3541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number795334
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number795334
License Number StateTX

VIII. Authorized Official

Name: MR. STEVEN J JEWELL
Title or Position: ADMINISTRATOR / CHIEF NURSING OFFIC
Credential: RN
Phone: 210-861-3541