Provider Demographics
NPI:1235490350
Name:HEART OF TEXAS HOME MEDICAL SERVICES
Entity Type:Organization
Organization Name:HEART OF TEXAS HOME MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TONI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DEER
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:936-577-1538
Mailing Address - Street 1:PO BOX 31
Mailing Address - Street 2:
Mailing Address - City:ROANS PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:77875-0031
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25373 BANKHEAD DR
Practice Address - Street 2:
Practice Address - City:BEDIAS
Practice Address - State:TX
Practice Address - Zip Code:77831-5259
Practice Address - Country:US
Practice Address - Phone:936-577-1538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9083207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty