Healthcare Provider Details

I. General information

NPI: 1346932126
Provider Name (Legal Business Name): MSC HEALTH TEXAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 SINGING OAKS STE 155
SPRING BRANCH TX
78070-6531
US

IV. Provider business mailing address

1305 E HOUSTON ST STE 403
SAN ANTONIO TX
78205-2034
US

V. Phone/Fax

Practice location:
  • Phone: 830-380-8012
  • Fax: 830-380-8013
Mailing address:
  • Phone: 210-775-1600
  • Fax: 210-742-1534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WD1100X
TaxonomyPeritoneal Dialysis Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code163WH0500X
TaxonomyHemodialysis Registered Nurse
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2472R0900X
TaxonomyRenal Dialysis Technician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANDRES GUTIERREZ
Title or Position: CEO
Credential:
Phone: 210-775-1600