Provider Demographics
NPI:1053783753
Name:ADAPTIVE DRIVING ACCESS OF CORPUS CHRISTI, LLC
Entity type:Organization
Organization Name:ADAPTIVE DRIVING ACCESS OF CORPUS CHRISTI, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-487-1969
Mailing Address - Street 1:3430 E SAM HOUSTON PKWY S
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-2330
Mailing Address - Country:US
Mailing Address - Phone:281-487-1969
Mailing Address - Fax:832-448-9382
Practice Address - Street 1:2201 GOLLIHAR RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78415-5321
Practice Address - Country:US
Practice Address - Phone:361-852-0922
Practice Address - Fax:361-852-0301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies