MEDICARE: VALLIC TEXAS 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	3747P1801X	Personal Care Attendant
2	251E00000X	Home Health Agency	008332	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

General Provider Information

NPI Number	:	1851495386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLIC TEXAS INC.

Provider Business Mailing Address
First Line	:	2819 NW LOOP 410 STE B
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-5105
Country	:	US
Telephone Number	:	210-521-1244
Fax Number	:	210-521-7324

Provider Business Practice Location Address
First Line	:	2819 NW LOOP 410 STE B
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-5105
Country	:	US
Telephone Number	:	210-521-1244
Fax Number	:	210-521-7324

Authorized Official
Title or Position	:	CFO/ADMINISTRATOR
Name	:	KIMBERLEY D WINN
Credential	:
Telephone Number	:	210-385-9500

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	03/30/2020

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Directions to “VALLIC TEXAS INC. ” Practice Location

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