Provider Demographics
NPI:1376155341
Name:XCEPTIONAL POST ACUTE CARE PLLC
Entity Type:Organization
Organization Name:XCEPTIONAL POST ACUTE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:IVO
Authorized Official - Middle Name:KELLI
Authorized Official - Last Name:ACHUO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:128-185-7520
Mailing Address - Street 1:105 S CHENANGO ST STE 2
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-6080
Mailing Address - Country:US
Mailing Address - Phone:281-857-5201
Mailing Address - Fax:
Practice Address - Street 1:105 S CHENANGO ST STE 2
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-6080
Practice Address - Country:US
Practice Address - Phone:281-857-5201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization