NPI Code Details Logo

NPI 1043536568

NPI 1043536568 : CSS, PB : ODESSA, TX

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1043536568
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    CSS, PB 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    04/08/2010
-----------------------------------------------------
    Last Update Date     |    12/06/2010
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    855 CENTRAL DR STE 31A 
-----------------------------------------------------
    City                 |    ODESSA
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    79761-4245
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    432-580-6523
-----------------------------------------------------
    Fax                  |    866-513-1428
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    201 E PARK AVE 
-----------------------------------------------------
    City                 |    SAN ANTONIO
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    78212-4657
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    PRESIDENT
-----------------------------------------------------
    Name                 |     JEFFREY ADAM SALTER 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    210-757-4650
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    251E00000X
-----------------------------------------------------
    Taxonomy Name        |    Home Health Agency
-----------------------------------------------------
    License Number       |    012358
-----------------------------------------------------
    License Number State |    TX
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.