Provider Demographics
NPI:1710486626
Name:THE MEDICAL TEAM, INC.
Entity Type:Organization
Organization Name:THE MEDICAL TEAM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE ACCOUNTS RECEIVABLE MGR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-227-9000
Mailing Address - Street 1:45 NE LOOP 410 STE 800
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-5837
Mailing Address - Country:US
Mailing Address - Phone:210-227-9000
Mailing Address - Fax:210-224-2020
Practice Address - Street 1:711 N CARANCAHUA ST STE 528
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78401-0535
Practice Address - Country:US
Practice Address - Phone:361-262-7730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-06
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX018707251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001029990Medicaid
TX018707OtherHEALTH AND HUMAN SERVICES COMMISSION