Healthcare Provider Details

I. General information

NPI: 1184199325
Provider Name (Legal Business Name): OPEN ARMS HEALTHCARE OF TEXAS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2018
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6018 WEST AVE STE 2
SAN ANTONIO TX
78213-2730
US

IV. Provider business mailing address

8150 SPRINGWOOD DR # 150B
IRVING TX
75063-5810
US

V. Phone/Fax

Practice location:
  • Phone: 210-979-8478
  • Fax: 210-979-8548
Mailing address:
  • Phone: 214-396-7397
  • Fax: 214-396-7397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANDREA CARRILLO
Title or Position: REGIONAL DIRECTOR
Credential:
Phone: 817-831-6500