Provider Demographics
NPI: | 1891857124 |
---|---|
Name: | WAGGONER AND THOMAS, INC. |
Entity Type: | Organization |
Organization Name: | WAGGONER AND THOMAS, INC. |
Other - Org Name: | ALL CARE INC. |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | HASKELENE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | THOMAS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 210-348-8805 |
Mailing Address - Street 1: | 4100 E PIEDRAS DR |
Mailing Address - Street 2: | SUITE 215 |
Mailing Address - City: | SAN ANTONIO |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78228-1401 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 210-348-8805 |
Mailing Address - Fax: | 210-745-3939 |
Practice Address - Street 1: | 4100 E PIEDRAS DR |
Practice Address - Street 2: | SUITE 215 |
Practice Address - City: | SAN ANTONIO |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78228-1401 |
Practice Address - Country: | US |
Practice Address - Phone: | 210-348-8805 |
Practice Address - Fax: | 210-745-3939 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-12-14 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 008105 | 251E00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |