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General NPI Number Information
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NPI Number | 1558686949
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH INTEGRATED SERVICES OF TEXAS, INC.
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 4758 VETERANS DR
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City | DALLAS
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State | TX
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Zip | 75216-7104
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Country | US
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Telephone | 214-702-4350
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Fax | 214-572-7322
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Provider Business Mailing Address
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Address Line | PO BOX 171295
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City | DALLAS
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State | TX
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Zip | 75217-1155
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Country | US
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Telephone | 214-702-4350
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Fax | 214-572-7322
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Authorized Official
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Title or Position | REGISTERED AGENT
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Name | TABETHA MCLEMORE
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Credential |
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Telephone | 214-753-6163
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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 | 013699
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 013699
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License Number State | TX
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