Provider Demographics
NPI:1952387268
Name:UNIVERSAL NURSING SERVICES, LLC
Entity Type:Organization
Organization Name:UNIVERSAL NURSING SERVICES, LLC
Other - Org Name:UNIVERSAL NURSING SERVICES OF TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MBA
Authorized Official - Phone:210-391-0819
Mailing Address - Street 1:11503 JONES MALTSBERGER RD
Mailing Address - Street 2:SUITE 1151
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2818
Mailing Address - Country:US
Mailing Address - Phone:210-568-8387
Mailing Address - Fax:210-568-8390
Practice Address - Street 1:11503 JONES MALTSBERGER RD
Practice Address - Street 2:SUITE 1151
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-2818
Practice Address - Country:US
Practice Address - Phone:210-568-8387
Practice Address - Fax:210-568-8390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-19
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011818251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX011818OtherHCSSA LICENSE NUMBER
TX45D1040928OtherCLIA WAIVER
TX1802233-01Medicaid
TX45D1040928OtherCLIA WAIVER