Provider Demographics
NPI:1689290835
Name:ARDENT NURSING AND HOMECARE OF TEXAS PLLC
Entity Type:Organization
Organization Name:ARDENT NURSING AND HOMECARE OF TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RENA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:210-601-3443
Mailing Address - Street 1:5804 BABCOCK RD # 369
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2134
Mailing Address - Country:US
Mailing Address - Phone:210-325-5240
Mailing Address - Fax:
Practice Address - Street 1:4040 BROADWAY ST STE 240
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-6300
Practice Address - Country:US
Practice Address - Phone:210-721-5048
Practice Address - Fax:210-721-5047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health