Provider Demographics
NPI:1588186258
Name:CARE MSO LLC
Entity Type:Organization
Organization Name:CARE MSO LLC
Other - Org Name:CARE MSO LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-226-3436
Mailing Address - Street 1:PO BOX 1299
Mailing Address - Street 2:
Mailing Address - City:ARANSAS PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78335-1299
Mailing Address - Country:US
Mailing Address - Phone:361-226-3914
Mailing Address - Fax:361-717-1820
Practice Address - Street 1:1711 W WHEELER AVE STE 3
Practice Address - Street 2:
Practice Address - City:ARANSAS PASS
Practice Address - State:TX
Practice Address - Zip Code:78336-4536
Practice Address - Country:US
Practice Address - Phone:361-226-3914
Practice Address - Fax:361-717-1820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherBILLING SERVICE