Provider Demographics
NPI:1972583078
Name:TENDERHEART HEALTH OUTCOMES, INC.
Entity Type:Organization
Organization Name:TENDERHEART HEALTH OUTCOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:WADLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-217-5198
Mailing Address - Street 1:1701 DIRECTORS BLVD STE 520
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78744-1105
Mailing Address - Country:US
Mailing Address - Phone:877-394-1860
Mailing Address - Fax:866-897-5881
Practice Address - Street 1:1701 DIRECTORS BLVD STE 520
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78744-1105
Practice Address - Country:US
Practice Address - Phone:877-394-1860
Practice Address - Fax:866-897-5881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-17
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X, 251E00000X
332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174927701Medicaid
TX174927702Medicaid
TX174927701Medicaid
TX5376910001Medicare NSC