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General NPI Number Information
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NPI Number | 1609051481
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Entity Type | Organization
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Legal Business Name | ESULANAH HOME SERVICES
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Dates
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Enumeration Date | 12/30/2007
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Last Update Date | 12/30/2007
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Provider Practice Location Address
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Address Line | 12317 DEERBROOK TRL
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City | AUSTIN
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State | TX
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Zip | 78750-1067
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Country | US
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Telephone | 512-997-0111
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Fax | 512-997-0116
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Provider Business Mailing Address
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Address Line | 402A W PALM VALLEY BLVD # 335
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City | ROUND ROCK
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State | TX
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Zip | 78664-4237
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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 | CARL VAUGHN
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Credential |
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Telephone | 512-997-0111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333300000X
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Taxonomy Name | Emergency Response System Companies
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License Number | PO0136
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License Number State | TX
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