Provider Demographics
NPI:1194779322
Name:HOUSE CALLS OF NEW MEXICO LLC
Entity type:Organization
Organization Name:HOUSE CALLS OF NEW MEXICO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & COO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:BICKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-535-8200
Mailing Address - Street 1:6303 COWBOYS WAY STE 600
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0329
Mailing Address - Country:US
Mailing Address - Phone:469-535-8200
Mailing Address - Fax:
Practice Address - Street 1:2129 OSUNA RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-1002
Practice Address - Country:US
Practice Address - Phone:505-884-4080
Practice Address - Fax:505-944-0094
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADDUS HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-20
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM30252776Medicaid
NM300521058Medicare PIN