Provider Demographics
NPI:1265816458
Name:VIGORCARE PARTNERS OF TEXAS
Entity Type:Organization
Organization Name:VIGORCARE PARTNERS OF TEXAS
Other - Org Name:VIGORCARE PEDIATRICS SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DAKOTA
Authorized Official - Middle Name:E
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-429-2913
Mailing Address - Street 1:1517 CENTRE PLACE DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-7273
Mailing Address - Country:US
Mailing Address - Phone:682-333-9309
Mailing Address - Fax:
Practice Address - Street 1:1517 CENTRE PLACE DRIVE
Practice Address - Street 2:SUITE 350
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205
Practice Address - Country:US
Practice Address - Phone:682-333-9309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX014136251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health