Provider Demographics
NPI:1346351426
Name:A-MED COMMUNITY HOSPICE-SAN ANTONIO, INC.
Entity Type:Organization
Organization Name:A-MED COMMUNITY HOSPICE-SAN ANTONIO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:CROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-935-1234
Mailing Address - Street 1:8900 EMMETT F LOWRY EXPY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-9116
Mailing Address - Country:US
Mailing Address - Phone:409-935-7925
Mailing Address - Fax:409-935-7926
Practice Address - Street 1:4903 GOLDEN QUAIL
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1584
Practice Address - Country:US
Practice Address - Phone:210-734-6300
Practice Address - Fax:210-734-6311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010427251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based