Provider Demographics
NPI:1770654501
Name:CARMEL HEALTH CARE SERVICES, PLLC
Entity Type:Organization
Organization Name:CARMEL HEALTH CARE SERVICES, PLLC
Other - Org Name:CARMEL HEALTH CARE SERVICES. PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MBANWITE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:972-871-8100
Mailing Address - Street 1:18601 LYNDON B JOHNSON FWY STE 425
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-5613
Mailing Address - Country:US
Mailing Address - Phone:972-871-8100
Mailing Address - Fax:972-695-5199
Practice Address - Street 1:18601 LYNDON B JOHNSON FWY STE 425
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-5613
Practice Address - Country:US
Practice Address - Phone:972-871-8100
Practice Address - Fax:972-695-5199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
013264OtherTEXAS DADS LICENSE
TX677949Medicare PIN