Provider Demographics
NPI:1083021364
Name:TRUCARE PERSONAL CARE SERVICES, LLC
Entity Type:Organization
Organization Name:TRUCARE PERSONAL CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:TANGULON
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-924-8133
Mailing Address - Street 1:3917 PYRACANTHA DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-4646
Mailing Address - Country:US
Mailing Address - Phone:214-924-8133
Mailing Address - Fax:844-273-5390
Practice Address - Street 1:1506 W PIONEER PKWY
Practice Address - Street 2:220
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-6230
Practice Address - Country:US
Practice Address - Phone:682-276-1715
Practice Address - Fax:844-273-5390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-17
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care