Provider Demographics
NPI:1790407005
Name:BUSH CAREER INSTITUTE
Entity Type:Organization
Organization Name:BUSH CAREER INSTITUTE
Other - Org Name:HEALTHCARE CAREERS INSTITUTE & VITAL CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KALETHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:972-861-2013
Mailing Address - Street 1:606 ORIOLE BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-3500
Mailing Address - Country:US
Mailing Address - Phone:972-861-2013
Mailing Address - Fax:214-889-8499
Practice Address - Street 1:606 ORIOLE BLVD STE 206
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-3500
Practice Address - Country:US
Practice Address - Phone:972-861-2013
Practice Address - Fax:214-889-8499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical LaboratoryGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1790407005Medicaid