Provider Demographics
NPI:1215007265
Name:HEALTH CARE DYNAMICS LLC
Entity Type:Organization
Organization Name:HEALTH CARE DYNAMICS LLC
Other - Org Name:BAPTIST HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:D
Authorized Official - Last Name:LANIER
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:903-932-1852
Mailing Address - Street 1:6760 OLD JACKSONVILLE HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-0566
Mailing Address - Country:US
Mailing Address - Phone:903-363-9932
Mailing Address - Fax:409-994-0400
Practice Address - Street 1:1085 I-10, BEAUMONT
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-7770
Practice Address - Country:US
Practice Address - Phone:409-994-0300
Practice Address - Fax:409-994-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008449251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1804858Medicaid
TX679403Medicare ID - Type Unspecified