Provider Demographics
NPI:1760435788
Name:RIGHTCARE MEDICAL
Entity Type:Organization
Organization Name:RIGHTCARE MEDICAL
Other - Org Name:RIGHTCARE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TONYE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAGOGOJACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-522-1515
Mailing Address - Street 1:PO BOX 613135
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75261-3135
Mailing Address - Country:US
Mailing Address - Phone:972-522-1515
Mailing Address - Fax:972-522-1717
Practice Address - Street 1:1106 N HIGHWAY 360
Practice Address - Street 2:SUITE 205
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-2554
Practice Address - Country:US
Practice Address - Phone:972-522-1515
Practice Address - Fax:972-522-1717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0066274332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158597801Medicaid
TX158597802Medicaid
TX158597802Medicaid