Provider Demographics
NPI:1205801495
Name:ADVANTX HOME CARE, INC.
Entity type:Organization
Organization Name:ADVANTX HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHANDA
Authorized Official - Middle Name:EASTRIDGE
Authorized Official - Last Name:REIFEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:903-813-8681
Mailing Address - Street 1:704 S SAM RAYBURN FWY
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-7261
Mailing Address - Country:US
Mailing Address - Phone:903-813-8681
Mailing Address - Fax:903-813-8702
Practice Address - Street 1:704 S SAM RAYBURN FWY
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-7261
Practice Address - Country:US
Practice Address - Phone:903-813-8681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251J00000X, 253Z00000X
TX007272251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX024438601Medicaid
TX459490Medicare ID - Type Unspecified