Provider Demographics
NPI:1629027420
Name:TILTON HEALTHCARE, INC.
Entity Type:Organization
Organization Name:TILTON HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CFO
Authorized Official - Prefix:
Authorized Official - First Name:AUBREY
Authorized Official - Middle Name:ONEIL
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:CFO-OWNER
Authorized Official - Phone:281-969-7585
Mailing Address - Street 1:2440 TEXAS PARKWAY
Mailing Address - Street 2:SUITE 140
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489
Mailing Address - Country:US
Mailing Address - Phone:281-969-7585
Mailing Address - Fax:281-969-7587
Practice Address - Street 1:2440 TEXAS PARKWAY
Practice Address - Street 2:SUITE 140
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489
Practice Address - Country:US
Practice Address - Phone:281-969-7585
Practice Address - Fax:281-969-7587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008658251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1638686Medicaid
TX16386801Medicaid
TX679443Medicare Oscar/Certification
TX16386801Medicaid