1871507863 NPI number — 1ST TEXAS HOME HEALTH

Table of content: (NPI 1871507863)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871507863 NPI number — 1ST TEXAS HOME HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
1ST TEXAS HOME HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FIRST TEXAS HOME HEALTH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871507863
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 147
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITESBORO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76273
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-564-9111
Provider Business Mailing Address Fax Number:
800-737-5601

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2535 HIGHWAY 82 EAST SUITE D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITESBORO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76273
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-564-9111
Provider Business Practice Location Address Fax Number:
800-737-5601
Provider Enumeration Date:
07/28/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PEARSON
Authorized Official First Name:
DENA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
903-564-9111

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  008046 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 173426101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: K04581930 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".