Provider Demographics
NPI:1649347162
Name:NATIONAL MEDICAL HOME CARE, INC.
Entity type:Organization
Organization Name:NATIONAL MEDICAL HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-822-0475
Mailing Address - Street 1:121 INTERPARK BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-1844
Mailing Address - Country:US
Mailing Address - Phone:210-822-0475
Mailing Address - Fax:210-822-0485
Practice Address - Street 1:1000 CROWN RIDGE BLVD
Practice Address - Street 2:STE. F
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-3218
Practice Address - Country:US
Practice Address - Phone:830-757-0900
Practice Address - Fax:830-757-0908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010971251J00000X, 253Z00000X, 385H00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190408801Medicaid
TX190408801Medicaid
TX5141Medicare PIN