MEDICARE: AXIS CARE GROUP HOME HEALTH SERVICES, 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	251E00000X	Home Health Agency	008482	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	HH297H	OTHER	TX	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1700801958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AXIS CARE GROUP HOME HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	800 BONAVENTURE WAY STE 153
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-8007
Country	:	US
Telephone Number	:	281-495-4845
Fax Number	:	281-495-4846

Provider Business Practice Location Address
First Line	:	800 BONAVENTURE WAY STE 153
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-8007
Country	:	US
Telephone Number	:	281-495-4845
Fax Number	:	281-495-4846

Authorized Official
Title or Position	:	PT/CFO
Name	:	MR. RAMIL ARRIESGADO CAPAO
Credential	:	PT
Telephone Number	:	281-495-4845

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	02/15/2023

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