MEDICARE: TEXAS ADULT DAY CARE CENTERS 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
1	261QA0600X	Adult Day Care Clinic/Center	118895	TX
2	261QA0600X	Adult Day Care Clinic/Center	114994	TX
3	261QA0600X	Adult Day Care Clinic/Center	120319	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000340100	OTHER	TX	ADULT CARE PROVIDER
2	001000983	OTHER	TX	ADULT CARE PROVIDER
3	001014580	OTHER	TX	ADULT CARE PROVIDER

General Provider Information

NPI Number	:	1457573230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS ADULT DAY CARE CENTERS INC.

Provider Business Mailing Address
First Line	:	6406 SAINT TROPEZ ST
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-6121
Country	:	US
Telephone Number	:	361-343-1593
Fax Number	:	361-334-6365

Provider Business Practice Location Address
First Line	:	3529 MORGAN AVE
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78405-2822
Country	:	US
Telephone Number	:	361-881-8736
Fax Number	:	361-362-0833

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. JOE OMMANI
Credential	:
Telephone Number	:	361-343-1593

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	11/16/2020

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