Provider Demographics
NPI:1588800320
Name:X-TRA HEALTH CARE SERVICES INC
Entity Type:Organization
Organization Name:X-TRA HEALTH CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GWENDOLYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SERIKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-388-0200
Mailing Address - Street 1:777 S CENTRAL EXPY STE 7H
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-7422
Mailing Address - Country:US
Mailing Address - Phone:214-388-0200
Mailing Address - Fax:214-388-0215
Practice Address - Street 1:777 S CENTRAL EXPY STE 7H
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-7422
Practice Address - Country:US
Practice Address - Phone:214-388-0200
Practice Address - Fax:214-388-0215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-29
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health