Provider Demographics
NPI:1376155341
Name:XCEPTIONAL POST ACUTE CARE PLLC
Entity type:Organization
Organization Name:XCEPTIONAL POST ACUTE CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:IVO
Authorized Official - Middle Name:KELLI
Authorized Official - Last Name:ACHUO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:128-185-7520
Mailing Address - Street 1:9819 WRIGHT DR
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-1756
Mailing Address - Country:US
Mailing Address - Phone:281-857-5201
Mailing Address - Fax:
Practice Address - Street 1:105 S CHENANGO ST STE 2
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-6080
Practice Address - Country:US
Practice Address - Phone:281-857-5201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-20
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No2471V0106XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular-Interventional TechnologyGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy