Provider Demographics
NPI:1538164652
Name:OPTIONAL CARE INC
Entity type:Organization
Organization Name:OPTIONAL CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JACOB
Authorized Official - Last Name:LAVERTY
Authorized Official - Suffix:
Authorized Official - Credentials:BA AND MHA
Authorized Official - Phone:972-756-0500
Mailing Address - Street 1:1231 GREENWAY DR
Mailing Address - Street 2:SUITE 380
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-2527
Mailing Address - Country:US
Mailing Address - Phone:975-756-0500
Mailing Address - Fax:972-756-0448
Practice Address - Street 1:1231 GREENWAY DR
Practice Address - Street 2:SUITE 380
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-2527
Practice Address - Country:US
Practice Address - Phone:975-756-0500
Practice Address - Fax:972-756-0448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007240251E00000X, 163WH0200X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered251E00000XAgenciesHome HealthGroup - Multi-Specialty
Not Answered163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXK06774547Medicare ID - Type Unspecified