=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942036488
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TX BILL-MED LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2024
-----------------------------------------------------
Last Update Date | 09/11/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 31614 SKY BLUE RDG
-----------------------------------------------------
City | FAIR OAKS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78015-4087
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-849-8344
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31614 SKY BLUE RDG
-----------------------------------------------------
City | FAIR OAKS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78015-4087
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-849-8344
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MICHELLE F LUBIANSKI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 210-849-8344
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------