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Organization
PEDIA PROS HOME HEALTH, INC.
Active
Organization
PEDIA PROS HOME HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TY MILLER (CHIEF EXECUTIVE OFFICER)
(210) 780-7250
Entity
Organization
Contact information
Practice address
24123 BOERNE STAGE RD, SUITE 207, SAN ANTONIO, TX 78255-9403
(210) 780-7250
(210) 802-4770
Mailing address
24123 BOERNE STAGE RD, SUITE 207, SAN ANTONIO, TX 78255-9403
(210) 780-7250
(210) 802-4770
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017015
HOME HEALTH LICENSE NUMBER
TX
Enumeration date
06/06/2015
Last updated
09/30/2015
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