Active NPI
Live Oak County
- Case Management Agency
- Three Rivers, TX
National Provider Identifier
1447445804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- License
- 001001677
- Legal business name
- LIVE OAK COUNTY
- Practice address
- 102 N Harborth Ave
Three Rivers, TX 78071 - Phone
- (361) 786-3820
- Fax
- (361) 786-3820
- NPI assigned
- Sep 10, 2007
- Last updated
- Apr 4, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ida Flores
- Title
- Nurse
- Phone
- (361) 449-8019
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | 001001677 | TX | Primary |
Addresses
Primary practice location
102 N Harborth Ave
Three Rivers, TX 78071
Mailing address
PO Box 699
George West, TX 78022-0699
Phone (361) 449-2733
Other practice location 1
204 Bowie St.
George West, TX 78022
Phone (361) 449-8043
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101029000936 | TX | Part B Supplier - Public Health/Welfare Agency | 4284828690 | Practice locations: George West, TX |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189382400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1680566400000",
"number": "1447445804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 699",
"city": "GEORGE WEST",
"state": "TX",
"postal_code": "780220699",
"telephone_number": "361-449-2733",
"fax_number": "361-449-3626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 N HARBORTH AVE",
"city": "THREE RIVERS",
"state": "TX",
"postal_code": "78071",
"telephone_number": "361-786-3820",
"fax_number": "361-786-3820"
}
],
"practiceLocations": [
{
"address_1": "204 Bowie St.",
"address_purpose": "LOCATION",
"city": "George West",
"state": "TX",
"postal_code": "78022",
"country_code": "US",
"telephone_number": "361-449-8043",
"fax_number": "361-449-1013",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "LIVE OAK COUNTY",
"organizational_subpart": "NO",
"enumeration_date": "2007-09-10",
"last_updated": "2023-04-04",
"certification_date": "2023-03-29",
"status": "A",
"authorized_official_last_name": "FLORES",
"authorized_official_first_name": "IDA",
"authorized_official_title_or_position": "NURSE",
"authorized_official_telephone_number": "361-449-8019"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "TX",
"license": "001001677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Three Rivers, TX
- Holly Christine Elzey, NP
- Fci Three Rivers
- Wayne Oliver Ghans, M.D.
- Jourdanton Hospital Corporation (Three Rivers Family Health Clinic)
- Linda Lewis, NP Wellness Center PLLC
- Damaris Marquez, LCSW
- Bianca Crystal Montalvo
- Premise Health of Texas Medical PA (Valero Employee Wellness Center)
- Cary A Pruski, DDS
- Soliz Physical Therapy PLLC (Momentum Physcial Therapy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.