Provider Demographics
NPI:1609001841
Name:HOME CARE SOURCE OF TEXAS, INC.
Entity Type:Organization
Organization Name:HOME CARE SOURCE OF TEXAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JO
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFONCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-954-4812
Mailing Address - Street 1:2500 WILCREST DR STE 308
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-2752
Mailing Address - Country:US
Mailing Address - Phone:713-954-4812
Mailing Address - Fax:713-954-4813
Practice Address - Street 1:2500 WILCREST DR STE 308
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-2752
Practice Address - Country:US
Practice Address - Phone:713-954-4812
Practice Address - Fax:713-954-4813
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME CARE SOURCE OF TEXAS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care