Provider Demographics
NPI:1235177395
Name:HUNTLEIGH HOME MEDICAL, LTD.
Entity Type:Organization
Organization Name:HUNTLEIGH HOME MEDICAL, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. OF THE GENERAL PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-225-7400
Mailing Address - Street 1:5626 RANDOLPH BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-6161
Mailing Address - Country:US
Mailing Address - Phone:210-225-7400
Mailing Address - Fax:
Practice Address - Street 1:5626 RANDOLPH BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-6161
Practice Address - Country:US
Practice Address - Phone:210-225-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX016863-0001OtherSECURE HORIZONS
TX530652OtherBLUE CROSS BLUE SHIELD
TX015531901Medicaid
TX016863-0001OtherPACIFCARE
TX1028466OtherUNITED HEALTHCARE/ACM
TX086384702Medicaid
TX086384701Medicaid
TX016863-0001OtherSECURE HORIZONS