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Organization
KMAC, INC
Active
Organization
KMAC, INC
Active
Other names
Guardian Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
TREVOR SHANNON (VP REVENUE CYCLE)
(937) 469-4275
Entity
Organization
Contact information
Practice address
4444 CORONA DR STE 211, CORPUS CHRISTI, TX 78411-4321
(361) 758-9336
(361) 758-9356
Mailing address
13737 NOEL RD STE 1300, DALLAS, TX 75240-1331
(361) 758-9336
(214) 491-4907
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
007780
TX
251E00000X
Home Health Agency
Primary
679129
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1511479-01
—
TX
05
—
151147901
—
TX
Enumeration date
10/03/2006
Last updated
09/11/2020
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