Provider Demographics
NPI:1700864121
Name:E MEDICAL GROUP OF NORTH TEXAS, INC.
Entity Type:Organization
Organization Name:E MEDICAL GROUP OF NORTH TEXAS, INC.
Other - Org Name:ANGELS CARE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:W
Authorized Official - Last Name:EDDINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-469-6739
Mailing Address - Street 1:2301 HIGHWAY 1187
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-6124
Mailing Address - Country:US
Mailing Address - Phone:817-469-6739
Mailing Address - Fax:801-801-3486
Practice Address - Street 1:106 S WASHBURN ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-1608
Practice Address - Country:US
Practice Address - Phone:940-627-6888
Practice Address - Fax:940-627-5174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010041251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457786Medicare Oscar/Certification