Provider Demographics
NPI:1023187119
Name:TEXAS OXYCARE, INC.
Entity Type:Organization
Organization Name:TEXAS OXYCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-655-5756
Mailing Address - Street 1:30 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-5927
Mailing Address - Country:US
Mailing Address - Phone:325-655-5756
Mailing Address - Fax:325-658-3993
Practice Address - Street 1:30 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-5927
Practice Address - Country:US
Practice Address - Phone:325-655-5756
Practice Address - Fax:325-658-3993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4416350001332B00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167891402Medicaid
TX167891402Medicaid