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General NPI Number Information
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NPI Number | 1275198624
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Entity Type | Organization
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Legal Business Name | WILDER CARE CORPORATION
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Dates
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Enumeration Date | 05/01/2019
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Last Update Date | 05/19/2022
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Provider Practice Location Address
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Address Line | 25132 OAKHURST DR STE 180
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City | SPRING
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State | TX
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Zip | 77386-1442
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Country | US
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Telephone | 281-402-8858
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Fax |
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Provider Business Mailing Address
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Address Line | 18611 GLENN HAVEN ESTATES DR
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City | SPRING
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State | TX
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Zip | 77379-2736
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MINDY WILDER
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Credential |
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Telephone | 832-919-3291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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