Provider Demographics
NPI:1265757520
Name:SOULAGER, INC.
Entity type:Organization
Organization Name:SOULAGER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-331-4211
Mailing Address - Street 1:121 RIVER BEND DR
Mailing Address - Street 2:APT 1306
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-3368
Mailing Address - Country:US
Mailing Address - Phone:512-331-4211
Mailing Address - Fax:512-591-7202
Practice Address - Street 1:121 RIVER BEND DR
Practice Address - Street 2:APT 1306
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-3368
Practice Address - Country:US
Practice Address - Phone:512-331-4211
Practice Address - Fax:512-591-7202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010589253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care