Provider Demographics
NPI:1679923452
Name:IN-DEPTH HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:IN-DEPTH HEALTHCARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-492-3156
Mailing Address - Street 1:1600 MOSSY RDG
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-9703
Mailing Address - Country:US
Mailing Address - Phone:214-492-3156
Mailing Address - Fax:972-780-0385
Practice Address - Street 1:1600 MOSSY RDG
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-9703
Practice Address - Country:US
Practice Address - Phone:214-492-3156
Practice Address - Fax:972-780-0385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health