Healthcare Provider Details

I. General information

NPI: 1265661268
Provider Name (Legal Business Name): BEXAR HEALTHCARE CONSORTIUM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2009
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5202 TEXANA DR APT 1414 SUITE 1414
SAN ANTONIO TX
78249-3788
US

IV. Provider business mailing address

5202 TEXANA DR APT 1414 SUITE 1414
SAN ANTONIO TX
78249-3788
US

V. Phone/Fax

Practice location:
  • Phone: 210-215-2414
  • Fax:
Mailing address:
  • Phone: 210-215-2414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN JAMES JEWELL
Title or Position: ADMINISTRATOR / CHIEF EXEC OFFICER
Credential: MBA, RN
Phone: 210-215-2414