Cordova Bay LTD

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

012304 Issued in TX

Legal business name

CORDOVA BAY LTD

Practice address

10207 Indiana Ave
Lubbock, TX 79423-4909

Phone

(806) 712-1110

NPI assigned

Mar 17, 2009

Organization subpart

No

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

Authorized official

Name

Ronald E Madison

Title

VP of General Partner

Phone

(806) 712-1110

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CALVERT HOME HEALTH CARE LTD Doing business as

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416614400000",
    "number": "1962643296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10207 INDIANA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794234909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10207 INDIANA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794234909",
            "telephone_number": "806-712-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDOVA BAY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2014-11-22",
        "status": "A",
        "authorized_official_last_name": "MADISON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VP OF GENERAL PARTNER",
        "authorized_official_telephone_number": "806-712-1110"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "012304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "679058",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CALVERT HOME HEALTH CARE LTD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paola Cordero
• Daniel Cordoba
• Ana Margarita Cordon Juarez, MD
• Cordova Bay LLC
• Cordova Bay LLC
• Lisa Michele Cordova, FNP-C
• Rebecca Ann Corley
• Cornelia S Deriese MD PA
• Cornerstone Audiology, PLLC
• Cornerstone OB-GYN PLLC

• All providers in Lubbock, TX
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.