Provider Demographics
NPI:1285727511
Name:ROXANNE M MCMEANS
Entity type:Organization
Organization Name:ROXANNE M MCMEANS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCMEANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-666-9268
Mailing Address - Street 1:3155 ACKERMAN RD STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78219-1529
Mailing Address - Country:US
Mailing Address - Phone:210-666-9268
Mailing Address - Fax:210-661-2804
Practice Address - Street 1:3155 ACKERMAN RD STE 106
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78219-1529
Practice Address - Country:US
Practice Address - Phone:210-666-9268
Practice Address - Fax:210-661-2804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010591251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679667Medicare Oscar/Certification