Organization
VICDOS HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HERITAGE EWAOLUWA OGUNMOLA (PROGRAM MANAGER)
(317) 607-5447
Entity
Organization
Contact information
Practice address
8797 MARBACH RD APT 7104, SAN ANTONIO, TX 78227-2383
(210) 985-6886
(210) 899-8013
Mailing address
19179 BLANCO RD STE 105, SAN ANTONIO, TX 78258-4009
(210) 985-6886
(210) 899-8013
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/12/2023
Last updated
07/16/2026
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