Provider Demographics
NPI:1033277330
Name:CARESTAT LLC
Entity Type:Organization
Organization Name:CARESTAT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-242-3000
Mailing Address - Street 1:13330 LEOPARD ST STE 21
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-4481
Mailing Address - Country:US
Mailing Address - Phone:361-242-3000
Mailing Address - Fax:361-242-3004
Practice Address - Street 1:13330 LEOPARD ST STE 21
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-4481
Practice Address - Country:US
Practice Address - Phone:361-242-3000
Practice Address - Fax:361-242-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X, 3747P1801X
TX003825251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001000699OtherTDADS
TX001000698OtherTDADS
TX0249559-01Medicaid
TX67-8094Medicare ID - Type Unspecified