Provider Demographics
NPI:1740821560
Name:INDEPENDENCE PLUS-TX, LLC
Entity type:Organization
Organization Name:INDEPENDENCE PLUS-TX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANILO
Authorized Official - Middle Name:R
Authorized Official - Last Name:COITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-366-7696
Mailing Address - Street 1:800 JORIE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2252
Mailing Address - Country:US
Mailing Address - Phone:800-366-7696
Mailing Address - Fax:
Practice Address - Street 1:136 OLD SAN ANTONIO RD STE 102
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-3338
Practice Address - Country:US
Practice Address - Phone:800-366-7696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INDEPENDENCE PLUS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-02
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care