FC of Texas Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

008793 Issued in TX

Legal business name

FC OF TEXAS INC

Doing business as

Intrepid USA Healthcare Services

Practice address

2410 Jack St
Wichita Falls, TX 76308-1006

Phone

(940) 696-9239

Fax

(940) 696-9678

NPI assigned

Nov 18, 2005

Organization subpart

No

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

Authorized official

Name

Mr. John M Kunysz Jr.

Title

Ceo

Phone

(214) 445-3750

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Intrepid USA Healthcare Services Doing business as

Electronic endpoints 1

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

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lauren Michelle Roach, OTR

  • Occupational Therapist
  • Wichita Falls, TX
  • NPI 1790306033
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1407838071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14841 DALLAS PKWY STE 625",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547641",
            "telephone_number": "214-445-3750",
            "fax_number": "214-445-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 JACK ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763081006",
            "telephone_number": "940-696-9239",
            "fax_number": "940-696-9678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FC OF TEXAS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "KUNYSZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-445-3750",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "008793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164891701",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Intrepid USA Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intrepid USA Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gary Allen Fashimpar, PHD, LCSW,LMFT
• Angela Sue Faubion, MSN, APRN, FNP- BC
• Hailee Faustner, PTA
• Louis John Favorite, PTA
• Keila Fawcett
• Glenda Sue Featherston
• Debra Felderhoff, NP
• Lauren Fenoglio, APRN, FNP-C
• Schondra Conyea Fenoglio, M.A., LPC
• David Michael Ferguson, FNP

• Home Health Agency in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.