1104965185 NPI number — APTUS HEALTH CARE P.L.L.C.

Table of content: (NPI 1104965185)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104965185 NPI number — APTUS HEALTH CARE P.L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APTUS HEALTH CARE P.L.L.C.
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:
APTUS THERAPY SERVICES
Provider Other Organization Name Type Code:
3
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:
1104965185
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5412 BRAND ST
Provider Second Line Business Mailing Address:
BLDG C-3
Provider Business Mailing Address City Name:
RIO GRANDE CITY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78582-9463
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-488-1818
Provider Business Mailing Address Fax Number:
956-488-1819

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5412 BRAND ST.
Provider Second Line Business Practice Location Address:
BLDG C-3
Provider Business Practice Location Address City Name:
RIO GRANDE CITY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78582-9463
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-488-1818
Provider Business Practice Location Address Fax Number:
956-488-1819
Provider Enumeration Date:
02/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SAENZ
Authorized Official First Name:
KARINA
Authorized Official Middle Name:
E
Authorized Official Title or Position:
BILLING CLERK
Authorized Official Telephone Number:
956-668-7433

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  612600001 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , with the licence number: 5255600001 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0400X , with the licence number: 67-6501 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0400X , with the licence number: 612600001 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0401X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 022017001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 022017002 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 52556001 . This is a "OT STATE BOARD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 612600001 . This is a "PT STATE BOARD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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