Provider Demographics
NPI:1922495225
Name:AXXESS HEALTH CARE PROVIDER
Entity Type:Organization
Organization Name:AXXESS HEALTH CARE PROVIDER
Other - Org Name:CONTOUR HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:469-693-0596
Mailing Address - Street 1:4200 BROADWAY AVE
Mailing Address - Street 2:12304
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-7585
Mailing Address - Country:US
Mailing Address - Phone:469-693-0596
Mailing Address - Fax:469-625-6227
Practice Address - Street 1:4200 BROADWAY AVE
Practice Address - Street 2:12304
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-7585
Practice Address - Country:US
Practice Address - Phone:469-693-0596
Practice Address - Fax:469-625-6227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX759980251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care