Intrepid of San Antonio Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

002732 Issued in TX

Legal business name

INTREPID OF SAN ANTONIO INC

Practice address

8632 Fredericksburg
Ste 209
San Antonio, TX 78240

Phone

(210) 408-0070

Fax

(210) 408-0071

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

Mrs. Cecelia Callis

Title

Vice President of Compliance

Phone

(214) 445-3750

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Intrepid USA Healthcare Services Doing business as

Locations

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256601600000",
    "number": "1972585552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN",
            "address_2": "5TH FLOOR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445074",
            "telephone_number": "214-445-3750",
            "fax_number": "214-445-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8632 FREDERICKSBURG",
            "address_2": "STE 209",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78240",
            "telephone_number": "210-408-0070",
            "fax_number": "210-408-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTREPID OF SAN ANTONIO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2009-10-27",
        "status": "A",
        "authorized_official_last_name": "CALLIS",
        "authorized_official_first_name": "CECELIA",
        "authorized_official_title_or_position": "VICE PRESIDENT OF COMPLIANCE",
        "authorized_official_telephone_number": "214-445-3750",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "002732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024610001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intrepid USA Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in San Antonio, TX
• Providers in San Antonio, 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 Oct 27, 2009; 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.