Provider Demographics
NPI:1699906784
Name:C.T. VIERS VENTURES, LLC
Entity type:Organization
Organization Name:C.T. VIERS VENTURES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUCK
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:903-413-0665
Mailing Address - Street 1:1330 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-2161
Mailing Address - Country:US
Mailing Address - Phone:903-885-5566
Mailing Address - Fax:903-885-7766
Practice Address - Street 1:1330 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-2161
Practice Address - Country:US
Practice Address - Phone:903-885-5566
Practice Address - Fax:903-885-7766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122841251B00000X, 251E00000X, 251G00000X, 251J00000X, 251T00000X, 305R00000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX315715801Medicaid
TX747844Medicare PIN