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General NPI Number Information
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NPI Number | 1124320445
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Entity Type | Organization
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Legal Business Name | X-CEL PEDIATRIC HOME HEALTH, LLC
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Dates
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Enumeration Date | 11/18/2010
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Last Update Date | 05/03/2016
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Provider Practice Location Address
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Address Line | 4207 GARDENDALE ST # 105
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3182
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Country | US
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Telephone | 210-949-0615
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Fax | 210-949-0946
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Provider Business Mailing Address
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Address Line | 4207 GARDENDALE ST # 105
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3182
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Country | US
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Telephone | 210-949-0615
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Fax | 210-949-0946
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Authorized Official
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Title or Position | MEMBER
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Name | J HUNTER BASS
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Credential |
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Telephone | 210-949-0615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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