Provider Demographics
NPI:1558702118
Name:TRUE CARE HOUSE CALLS OF TEXAS LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:TRUE CARE HOUSE CALLS OF TEXAS LIMITED LIABILITY COMPANY
Other - Org Name:TRUE CARE OF TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:BARKUS
Authorized Official - Last Name:LOGSDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-630-6970
Mailing Address - Street 1:849 E INDUSTRY ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GIDDINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78942-4301
Mailing Address - Country:US
Mailing Address - Phone:254-630-6970
Mailing Address - Fax:
Practice Address - Street 1:849 E INDUSTRY ST
Practice Address - Street 2:SUITE B
Practice Address - City:GIDDINGS
Practice Address - State:TX
Practice Address - Zip Code:78942-4301
Practice Address - Country:US
Practice Address - Phone:254-630-6970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9083363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty