Provider Demographics
NPI:1871274019
Name:INNOVACARE TEXAS PHYSICIANS GROUP, PLLC
Entity type:Organization
Organization Name:INNOVACARE TEXAS PHYSICIANS GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:WILL
Authorized Official - Last Name:ABBOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-702-8383
Mailing Address - Street 1:1672 INDEPENDENCE DR STE 310
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-3982
Mailing Address - Country:US
Mailing Address - Phone:830-730-5025
Mailing Address - Fax:830-730-4207
Practice Address - Street 1:723 HILL COUNTRY DR STE C
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6043
Practice Address - Country:US
Practice Address - Phone:830-792-5800
Practice Address - Fax:830-896-2625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty