Basic Information
Provider Information
NPI: 1750713939
EntityType: 2
ReplacementNPI:  
OrganizationName: CANTEX HOME HEALTH SAN ANTONIO LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: THERACARE HOME HEALTH
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2537 GOLDEN BEAR DR
Address2:  
City: CARROLLTON
State: TX
PostalCode: 750062377
CountryCode: US
TelephoneNumber: 2149544114
FaxNumber: 2148713057
Practice Location
Address1: 7400 LOUIS PASTEUR DR STE 101
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782294510
CountryCode: US
TelephoneNumber: 2102310435
FaxNumber: 2102340440
Other Information
ProviderEnumerationDate: 07/30/2013
LastUpdateDate: 12/15/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: UNDERHILL
AuthorizedOfficialFirstName: ROBIN
AuthorizedOfficialMiddleName: F
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 2149544114
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X TXY AgenciesHome Health 

No ID Information.


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