Provider Demographics
NPI:1639184047
Name:DISCOVERY AT HOME IN TEXAS, INC
Entity Type:Organization
Organization Name:DISCOVERY AT HOME IN TEXAS, INC
Other - Org Name:NICKTOO HEALTH CARE SERVICES, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:CUNDIFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-398-6214
Mailing Address - Street 1:27299 RIVERVIEW CENTER
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-4322
Mailing Address - Country:US
Mailing Address - Phone:239-679-2080
Mailing Address - Fax:239-676-2089
Practice Address - Street 1:6401 OHIO DRIVE SUITE 1107
Practice Address - Street 2:SUITE 1107
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-6702
Practice Address - Country:US
Practice Address - Phone:469-808-9145
Practice Address - Fax:469-808-9146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
679350Medicare Oscar/Certification