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General NPI Number Information
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NPI Number | 1235093725
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Entity Type | Organization
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Legal Business Name | EXCELACARE HOMECARE PERMIAN BASIN LLC
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 1900 S GREGG ST STE C
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City | BIG SPRING
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State | TX
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Zip | 79720-5462
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Country | US
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Telephone | 432-235-1164
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Fax | 432-235-1169
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Provider Business Mailing Address
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Address Line | 101 W RENNER RD STE 420
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City | RICHARDSON
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State | TX
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Zip | 75082-2022
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Country | US
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Telephone | 972-468-8070
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | DONNIE MABERRY
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Credential |
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Telephone | 972-468-8070
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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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