1346386679 NPI number — R & K SPECIALIZED HOMES, INC.

Table of content: (NPI 1346386679)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346386679 NPI number — R & K SPECIALIZED HOMES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
R & K SPECIALIZED HOMES, 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:
1346386679
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/24/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 17897
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78217-0897
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-710-4999
Provider Business Mailing Address Fax Number:
210-568-6213

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8802 BROADWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78217-6318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-710-4999
Provider Business Practice Location Address Fax Number:
210-568-6213
Provider Enumeration Date:
01/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HERNANDEZ
Authorized Official First Name:
ESEQUIEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/OWNER
Authorized Official Telephone Number:
210-843-4413

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  01007452 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 315P00000X , with the licence number: 000721501 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 315P00000X , with the licence number: 001018537 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 315P00000X , with the licence number: 001018787 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 315P00000X , with the licence number: 001019163 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 315P00000X , with the licence number: 001020880 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 315P00000X , with the licence number: 01021060 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 000721501 . This is a "INTRIGUE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001031043 . This is a "RIMWOOD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001028361 . This is a "CLYDE DENT" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 01007452 . This is a "HCS PROGRAM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001019163 . This is a "QUAIL CIRCLE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001020880 . This is a "OAK LEDGE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001021060 . This is a "TIMBERHILL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001018787 . This is a "SHADY BREEZE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001018537 . This is a "SQUANTO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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