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General NPI Number Information
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NPI Number | 1275836918
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Entity Type | Organization
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Legal Business Name | KDC HEALTHCARE PARTNERS
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Dates
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Enumeration Date | 12/20/2010
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 1330 CHURCH ST
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City | SULPHUR SPRINGS
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State | TX
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Zip | 75482-2161
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Country | US
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Telephone | 888-466-3016
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Fax | 888-702-7991
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Provider Business Mailing Address
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Address Line | 4605 TEXAS BLVD
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City | TEXARKANA
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State | TX
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Zip | 75503-3028
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Country | US
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Telephone | 903-792-0716
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Fax | 903-792-0719
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Authorized Official
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Title or Position | COO
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Name | CHRISTOPHER STAYTON CLEMENS
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Credential | RN
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Telephone | 903-792-0716
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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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