Provider Demographics
NPI:1679583777
Name:AXIOM HOME HEALTH INC.
Entity Type:Organization
Organization Name:AXIOM HOME HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:THIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-205-5226
Mailing Address - Street 1:9514 CONSOLE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2043
Mailing Address - Country:US
Mailing Address - Phone:210-639-9112
Mailing Address - Fax:210-366-9042
Practice Address - Street 1:9514 CONSOLE DR STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-639-9112
Practice Address - Fax:210-366-9042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010629251E00000X
TX10629251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747169OtherHOSPICE
74-7169OtherMEDICARE NUMBER
TX=========OtherTIN