Provider Demographics
NPI:1366856205
Name:ESOTERIC HEALTH SYSTEM LLC
Entity Type:Organization
Organization Name:ESOTERIC HEALTH SYSTEM LLC
Other - Org Name:ESOTERIC HEALTHCARE MANAGEMENT LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JENETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-396-2806
Mailing Address - Street 1:PO BOX 41060
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75241-0060
Mailing Address - Country:US
Mailing Address - Phone:214-396-3805
Mailing Address - Fax:214-484-5071
Practice Address - Street 1:11325 PEGASUS ST
Practice Address - Street 2:SUITE E260
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-5219
Practice Address - Country:US
Practice Address - Phone:214-396-3805
Practice Address - Fax:214-484-5071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies