NPIMap

Organization Active NPI

Rio Bravo Health System LLC

Doing business as Maverick Home Health

  • Home Health Agency
  • Eagle Pass, TX
National Provider Identifier
1093869323
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
008267 Issued in TX
Legal business name
RIO BRAVO HEALTH SYSTEM LLC
Doing business as
Maverick Home Health
Maverick Home Health Agency
Practice address
2822 N Veterans Blvd Ste a
Eagle Pass, TX 78852-6697
Phone
(830) 773-5330
Fax
(830) 773-4078
NPI assigned
Jan 23, 2007
Last updated
Nov 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jose Hernandez, R.N.
Title
Director
Phone
(830) 773-5330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 008267 TX Primary

Addresses

Primary practice location

2822 N Veterans Blvd Ste a
Eagle Pass, TX 78852-6697

Mailing address

2822 N Veterans Blvd Ste a
Eagle Pass, TX 78852-6697
Phone (830) 773-5330

Other identifiers 3

IdentifierTypeStateIssuer
1093869323MedicaidTX
088263102MedicaidTX
001012468MedicaidTX

Other names 2

  • Maverick Home Health Doing business as
  • Maverick Home Health Agency Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030513000008 TX Part A Provider - Home Health Agency 3476463068 Practice locations: Eagle Pass, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093869323. Details of each certification follow.

Home health agency certification: CCN 677144

Legal name
RIO BRAVO HEALTH SYSTEM LLC
Doing business as
MAVERICK HOME HEALTH AGENCY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 6, 1988
Last certification
Mar 12, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Apr 10, 2001 in TX
Enrollment address
2822 N Veterans Blvd
Ste a
Eagle Pass, TX 78852-4391

Care Compare: Home health agency

Medicare Care Compare
Listed as
Maverick Home Health AgencyCCN 677144 · All quality measures
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Apr 6, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0937180Maverick Home Health2822 N Veterans Blvd Ste a, Eagle Pass, TX 78852Certificate of waiverDec 11, 2027

National Provider Directory

National Provider Directory

Locations

1879 Loop 3443
Ste 5
Eagle Pass, TX 78852
Phone (830) 758-0660

2822 N Veterans Blvd
Ste A
Eagle Pass, TX 78852
Phone (830) 773-5330

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Rio Bravo Health System LLC Organization, Eagle Pass, TX LLC Limited Partnership Interest Jul 31, 2002 100%
Victor Alonzo Gonzalez Individual 5% Or Greater Direct Ownership Interest Sep 28, 2005 40%
Limited Partnership Interest Jul 31, 2002
Jose Hernandez Individual 5% Or Greater Direct Ownership Interest Sep 28, 2005 60%
W-2 Managing Employee Sep 28, 2005 60%

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 20

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1093869323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2822 N VETERANS BLVD STE A",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788526697",
            "telephone_number": "830-773-5330",
            "fax_number": "830-773-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2822 N VETERANS BLVD STE A",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788526697",
            "telephone_number": "830-773-5330",
            "fax_number": "830-773-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIO BRAVO HEALTH SYSTEM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "830-773-5330",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "008267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093869323",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088263102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001012468",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maverick Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maverick Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagle Pass, TX

Sources for this page

Verify at the official NPI Registry.