Healthcare Provider Details

I. General information

NPI: 1609854447
Provider Name (Legal Business Name): BEXAR CARE HOME MEDICAL EQUIPMENT AND SUPPLY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7410 JOHN SMITH STE 108
SAN ANTONIO TX
78229
US

IV. Provider business mailing address

P.O. BOX 29366
SAN ANTONIO TX
78229
US

V. Phone/Fax

Practice location:
  • Phone: 210-614-3804
  • Fax: 210-614-3805
Mailing address:
  • Phone: 210-614-3804
  • Fax: 210-614-3805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0038579
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number0038579
License Number StateTX

VIII. Authorized Official

Name: MS. ALICIA CORREA
Title or Position: CEO
Credential: RN BSN MBA
Phone: 210-614-3804