Provider Demographics
NPI:1841244258
Name:APICON HOME HEALTH AGENCY , INC
Entity Type:Organization
Organization Name:APICON HOME HEALTH AGENCY , INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON/ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:OBILOM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:512-249-0899
Mailing Address - Street 1:1850 ROUND ROCK AVENUE
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4024
Mailing Address - Country:US
Mailing Address - Phone:512-249-0899
Mailing Address - Fax:512-249-0892
Practice Address - Street 1:1850 ROUND ROCK AVENUE
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4024
Practice Address - Country:US
Practice Address - Phone:512-249-0899
Practice Address - Fax:512-249-0892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007626251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX14799821Medicaid
TX007626OtherLICENSE
TX147998201Medicaid
TX147998201Medicaid
TX679088Medicare Oscar/Certification