Provider Demographics
NPI:1215460373
Name:BV TEXAS HOME CARE LLC
Entity type:Organization
Organization Name:BV TEXAS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-201-4056
Mailing Address - Street 1:983 WHITEHEAD DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-1463
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:983 WHITEHEAD DR
Practice Address - Street 2:SUITE 102
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-1463
Practice Address - Country:US
Practice Address - Phone:682-205-3366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care