Provider Demographics
NPI:1659853679
Name:TOTAL CARE HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:TOTAL CARE HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MSN APRN FNP-C
Authorized Official - Phone:817-220-9100
Mailing Address - Street 1:PO BOX 1850
Mailing Address - Street 2:
Mailing Address - City:SPRINGTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:76082-1850
Mailing Address - Country:US
Mailing Address - Phone:817-220-9100
Mailing Address - Fax:817-220-9109
Practice Address - Street 1:335 E. HWY 199
Practice Address - Street 2:
Practice Address - City:SPRINGTOWN
Practice Address - State:TX
Practice Address - Zip Code:76082
Practice Address - Country:US
Practice Address - Phone:817-220-9100
Practice Address - Fax:817-220-9109
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOTAL CARE HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-06
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9830111N00000X
208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX318508401Medicaid