MEDICARE: TENDERHEART HEALTH OUTCOMES, 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	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies		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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972583078
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENDERHEART HEALTH OUTCOMES, INC.

Provider Business Mailing Address
First Line	:	1701 DIRECTORS BLVD STE 520
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-1105
Country	:	US
Telephone Number	:	877-394-1860
Fax Number	:	866-897-5881

Provider Business Practice Location Address
First Line	:	1701 DIRECTORS BLVD STE 520
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-1105
Country	:	US
Telephone Number	:	877-394-1860
Fax Number	:	866-897-5881

Authorized Official
Title or Position	:	COO
Name	:	MR. LAWRENCE WADLE
Credential	:
Telephone Number	:	512-217-5198

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	02/27/2024

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