Provider Demographics
NPI:1588031405
Name:INNOVATIVE INDEPENDENCE INC.
Entity Type:Organization
Organization Name:INNOVATIVE INDEPENDENCE INC.
Other - Org Name:PARA DRIVING AIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SLATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-655-5438
Mailing Address - Street 1:10624 N IH 35
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-6626
Mailing Address - Country:US
Mailing Address - Phone:210-655-5438
Mailing Address - Fax:210-655-5573
Practice Address - Street 1:10624 N IH 35
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-6626
Practice Address - Country:US
Practice Address - Phone:210-655-5438
Practice Address - Fax:210-655-5573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service