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General NPI Number Information
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NPI Number | 1124356621
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Entity Type | Organization
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Legal Business Name | BKCP,LLC
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Dates
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Enumeration Date | 11/23/2009
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Last Update Date | 11/23/2009
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Provider Practice Location Address
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Address Line | 314 E HIGHLAND MALL BLVD SUITE 103
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City | AUSTIN
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State | TX
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Zip | 78752-3735
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Country | US
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Telephone | 512-610-0808
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Fax | 512-610-0810
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Provider Business Mailing Address
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Address Line | 100 LARIAT DR
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City | GEORGETOWN
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State | TX
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Zip | 78633-4568
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Country | US
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Telephone | 512-610-0808
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Fax | 512-610-0810
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. CARLEY JOHN TOBIAS
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Credential |
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Telephone | 512-610-0808
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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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