Provider Demographics
NPI:1508927112
Name:CARESTAT PROVIDER SERVICES
Entity Type:Organization
Organization Name:CARESTAT PROVIDER SERVICES
Other - Org Name:CARESTAT HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-664-1213
Mailing Address - Street 1:406 ALTO ST
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-5908
Mailing Address - Country:US
Mailing Address - Phone:956-664-1213
Mailing Address - Fax:956-664-2449
Practice Address - Street 1:406 ALTO ST
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-5908
Practice Address - Country:US
Practice Address - Phone:956-664-1213
Practice Address - Fax:956-664-2449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1699780478251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1699780478OtherDEPARTMENT OF HEALTH SERV