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General NPI Number Information
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NPI Number | 1215075353
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Entity Type | Organization
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Legal Business Name | TEXCARE ADULT DAY SERVICES
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1915 LA MANDA BLVD
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City | SAN ANTONIO
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State | TX
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Zip | 78201-2228
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Country | US
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Telephone | 210-541-8111
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Fax | 210-541-8110
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Provider Business Mailing Address
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Address Line | 1915 LA MANDA BLVD
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City | SAN ANTONIO
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State | TX
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Zip | 78201-2228
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Country | US
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Telephone | 210-541-8111
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Fax | 210-541-8110
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LAWRENCE AGBOO OSEGHAE
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Credential | M.B.A., R.N.
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Telephone | 210-541-8111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 117124
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License Number State | TX
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