Provider Demographics
NPI:1659372589
Name:TEXAS MEDICAL SERVICES, LP
Entity Type:Organization
Organization Name:TEXAS MEDICAL SERVICES, LP
Other - Org Name:MEDI HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:409-835-2828
Mailing Address - Street 1:1085 INTERSTATE 10 N
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-4816
Mailing Address - Country:US
Mailing Address - Phone:409-835-2828
Mailing Address - Fax:409-835-2129
Practice Address - Street 1:1085 INTERSTATE 10 N
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-4816
Practice Address - Country:US
Practice Address - Phone:409-835-2828
Practice Address - Fax:409-835-2129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008172251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH032HOtherBCBS OF TEXAS
TXK04594717Medicaid
TXHH032HOtherBCBS OF TEXAS
459471Medicare PIN