Provider Demographics
NPI:1255312427
Name:CENTRAL TEXAS HOME HEALTH
Entity Type:Organization
Organization Name:CENTRAL TEXAS HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-538-2296
Mailing Address - Street 1:9310 BROADWAY ST
Mailing Address - Street 2:SUITE 201 BLDG 2
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5907
Mailing Address - Country:US
Mailing Address - Phone:210-824-6801
Mailing Address - Fax:210-824-6886
Practice Address - Street 1:9310 BROADWAY ST
Practice Address - Street 2:SUITE 201 BLDG 2
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5907
Practice Address - Country:US
Practice Address - Phone:210-824-6801
Practice Address - Fax:210-824-6886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002129251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677270Medicare ID - Type UnspecifiedMEDICARE NUMBER