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NPI Code Detail

MEDICARE: TEXAS INDEPENDENCE HEALTH PLAN INC.

MEDICARE: TEXAS INDEPENDENCE HEALTH PLAN INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1302R00000XHealth Maintenance Organization

General Provider Information

NPI Number : 1083398457
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEXAS INDEPENDENCE HEALTH PLAN INC.
Provider Business Mailing Address
First Line : 1908 N LAURENT ST STE 250
Second Line :
City : VICTORIA
State : TX
Zip : 77901-5417
Country : US
Telephone Number : 361-576-0694
Fax Number :
Provider Business Practice Location Address
First Line : 1908 N LAURENT ST STE 250
Second Line :
City : VICTORIA
State : TX
Zip : 77901-5417
Country : US
Telephone Number : 361-576-0694
Fax Number :
Authorized Official
Title or Position : CEO/EXECUTIVE DIRECTOR
Name : MR. DEVAN DEKOWSKI
Credential :
Telephone Number : 361-576-0694
Provider Enumeration Date : 06/14/2023
Last Update Date : 06/14/2023

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Directions to “TEXAS INDEPENDENCE HEALTH PLAN INC. ” Practice Location

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