Healthcare Provider Details

I. General information

NPI: 1487719308
Provider Name (Legal Business Name): HANDSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 11/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6487 WHITBY RD
SAN ANTONIO TX
78240-2131
US

IV. Provider business mailing address

6487 WHITBY RD
SAN ANTONIO TX
78240-2131
US

V. Phone/Fax

Practice location:
  • Phone: 210-614-1661
  • Fax: 210-692-1524
Mailing address:
  • Phone: 210-614-1661
  • Fax: 210-692-1524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number117405
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number123357
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number123265
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number117406
License Number StateTX

VIII. Authorized Official

Name: GAY BELLAMY
Title or Position: PRESIDENT
Credential:
Phone: 210-614-1657