Provider Demographics
NPI:1336280536
Name:OLI-EAGLE PASS INC.
Entity Type:Organization
Organization Name:OLI-EAGLE PASS INC.
Other - Org Name:TOTAL CARE HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-256-9045
Mailing Address - Street 1:451 BANDERA RD STE 9
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-5555
Mailing Address - Country:US
Mailing Address - Phone:210-256-9045
Mailing Address - Fax:210-256-8873
Practice Address - Street 1:451 BANDERA RD STE 9
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-5555
Practice Address - Country:US
Practice Address - Phone:210-256-9045
Practice Address - Fax:210-256-8873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008834251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health