Provider Demographics
NPI:1295447555
Name:BEXARCARE PEDIATRIC HOME HEALTHCARE
Entity type:Organization
Organization Name:BEXARCARE PEDIATRIC HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-267-7662
Mailing Address - Street 1:1552 WESTVIEW COURT DR
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:78133-6391
Mailing Address - Country:US
Mailing Address - Phone:210-267-7662
Mailing Address - Fax:
Practice Address - Street 1:1552 WESTVIEW COURT DR
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:TX
Practice Address - Zip Code:78133-6391
Practice Address - Country:US
Practice Address - Phone:210-267-7662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care