Provider Demographics
NPI:1538125752
Name:ACCESS HEALTHCARE OF TEXAS, INC.
Entity Type:Organization
Organization Name:ACCESS HEALTHCARE OF TEXAS, INC.
Other - Org Name:RIO GRANDE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RNC
Authorized Official - Phone:915-772-3529
Mailing Address - Street 1:7717 LOCKHEED DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-2464
Mailing Address - Country:US
Mailing Address - Phone:915-772-3529
Mailing Address - Fax:915-772-3580
Practice Address - Street 1:7717 LOCKHEED DR
Practice Address - Street 2:SUITE E
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-2464
Practice Address - Country:US
Practice Address - Phone:915-772-3529
Practice Address - Fax:915-772-3580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009948251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167102601Medicaid
HH324HOtherBC/BS
HH324HOtherBC/BS