INTREPID OF WEST TEXAS INC (NPI# 1104808781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104808781 |
| Entity Type | Organization |
| Organization Name | INTREPID OF WEST TEXAS INC |
| Other Organization Name | INTREPID USA HEALTHCARE SERVICES |
| Practice Address |
3310 Loop 306 San Angelo TX 76904 |
| Mailing Address |
4055 Valley View Ln Ste 750 Dallas TX 75244-5074 |
| Practice Telephone | 3256585550 |
| Practice Fax Number | 3256588850 |
| Mailing Telephone | 2144453750 |
| Mailing Fax Number | 2144453902 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2018-06-12 |
| Authorized Official Name | MR. JOHN M. KUNYSZ JR. (CEO) |
| Authorized Official Telephone | 2144453750 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 008792 | TX | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 166971501 | 05 |
| Other Name | Type Code |
|---|---|
| Intrepid USA Healthcare Services | Doing Business As Name - Organization |
| Street Address |
3310 LOOP 306 |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407342702 | Mark Wandal Duncan | Specialist/Technologist | 2237 South Jackson, San Angelo, TX 76904 | 2018-07-10 |
| 1700267259 | Sheila Patterson | Nurse Practitioner | 4251 Sunset Drive, San Angelo, TX 76904 | 2015-06-10 |
| 1346649316 | Mason William Mcclintock | Dentist | 2402 College Hills Blvd. Building 1, Building 1, San Angelo, TX 76904 | 2014-08-15 |
| 1265855712 | Lynn M. Thebo, Lcsw, Pllc | Social Worker | 3109 Southwest Blvd. Ste. B, San Angelo, TX 76904 | 2014-02-03 |
| 1487077459 | Lynn Marie Thebo | Social Worker | 3109 Southwest Blvd., Ste. B, San Angelo, TX 76904 | 2014-01-28 |
| 1558646521 | John Porter Parker Jr. | Pharmacist | 3705 Threewn Trail, San Angelo, TX 76904 | 2011-10-20 |
| 1568772036 | Medical Alliance Group of Texas, LLC | Durable Medical Equipment & Medical Supplies | 2525 S Johnson Ste A, San Angelo, TX 76904 | 2010-10-18 |
| 1578796710 | Jennifer L White | Physical Therapist | 2237 S. Jackson, San Angelo, TX 76904 | 2009-09-03 |
| 1548443203 | Kelly K. Sawyer, D.d.s., P.a. | Dentist | 3013 W. Loop 306, San Angelo, TX 76904 | 2007-12-17 |
| 1023224789 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 1706 Idaho Avenue, San Angelo, TX 76904 | 2007-05-16 |
| Find all providers in zip 76904 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346570769 | 4c2w, LLC | Home Health | 3133 Executive Dr, San Angelo, TX 76904-6801 | 2010-01-07 |
| 1417192188 | Dea Health & Educational Services, Inc. | Home Health | 10764 Dennis Dr., San Angelo, TX 76901 | 2008-12-10 |
| 1518139237 | West Texas Healthcare LLC | Home Health | 423 S Irving St, St.1, San Angelo, TX 76903-6940 | 2008-04-02 |
| 1720103526 | Angelo Healthcare Services, Inc. | Home Health | 5028-a Knickerbocker Road, San Angelo, TX 76904 | 2007-03-20 |
| 1285653493 | Home Preferred Senior Care 9, LLC | Home Health | 3180 Executive Dr Ste 109, San Angelo, TX 76904-6837 | 2006-07-19 |
| 1467483362 | Concho Valley Hhc of West Tx LLC | Home Health | 430 W Beauregard Ave Ste B, San Angelo, TX 76903 | 2006-07-06 |
| 1962453266 | West Texas LLC | Home Health | 215 S Irving St, Suite 215, San Angelo, TX 76903-6421 | 2006-05-12 |
| 1386601417 | Carter Healthcare of San Angelo, LLC | Home Health | 2725 Sherwood Way, Suite 700, San Angelo, TX 76901-3040 | 2006-05-01 |
| 1780668988 | Nurses Unlimited Inc | Home Health | 3131 Executive Dr, San Angelo, TX 76904-6801 | 2005-12-01 |
| 1942205125 | 1st Texas Home Health of San Angelo, Inc. | Home Health | 3308 Foster St, San Angelo, TX 76903-9314 | 2005-06-15 |
| Find all providers in SAN ANGELO | ||||
| City | SAN ANGELO |
| Zip Code | 76904 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.