Provider Demographics
NPI:1497231724
Name:AXON HOME HEALTH SERVICES CORP
Entity Type:Organization
Organization Name:AXON HOME HEALTH SERVICES CORP
Other - Org Name:AXON HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LAUREANO
Authorized Official - Middle Name:E
Authorized Official - Last Name:BALSEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:AGNP-C
Authorized Official - Phone:832-866-8145
Mailing Address - Street 1:18514 GREEN LAND WAY STE C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-7969
Mailing Address - Country:US
Mailing Address - Phone:832-288-3001
Mailing Address - Fax:832-288-3004
Practice Address - Street 1:18514 GREEN LAND WAY STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7969
Practice Address - Country:US
Practice Address - Phone:832-288-3001
Practice Address - Fax:832-288-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health