Provider Demographics
NPI:1609854447
Name:BEXAR CARE HOME MEDICAL EQUIPMENT AND SUPPLY, LLC
Entity Type:Organization
Organization Name:BEXAR CARE HOME MEDICAL EQUIPMENT AND SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORREA
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN MBA
Authorized Official - Phone:210-614-3804
Mailing Address - Street 1:P.O. BOX 29366
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229
Mailing Address - Country:US
Mailing Address - Phone:210-614-3804
Mailing Address - Fax:210-614-3805
Practice Address - Street 1:7410 JOHN SMITH
Practice Address - Street 2:STE 108
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-614-3804
Practice Address - Fax:210-614-3805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0038579332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX016486501Medicaid
TX016486504Medicaid