1679245625 NPI number — UNITED HOME RENAL CARE, INC.

Table of content: (NPI 1679245625)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679245625 NPI number — UNITED HOME RENAL CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED HOME RENAL CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679245625
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
709 ANGELITA DRIVE SUITE C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESLACO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78599
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-392-3662
Provider Business Mailing Address Fax Number:
210-272-9340

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
709 ANGELITA DRIVE SUITE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESLACO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78599
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-392-3662
Provider Business Practice Location Address Fax Number:
210-272-9340
Provider Enumeration Date:
09/29/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SAUCEDA
Authorized Official First Name:
GUADALUPE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CEO/ADMINISTRATOR
Authorized Official Telephone Number:
956-392-3662

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251F00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QE0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BD1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 021719 . This is a "THHS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1679245625 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".