Provider Demographics
NPI:1255507406
Name:INTERIM HEALTH CARE OF WEST TEXAS
Entity Type:Organization
Organization Name:INTERIM HEALTH CARE OF WEST TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MARKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:806-771-0995
Mailing Address - Street 1:3223 S LOOP 289 STE 210
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-1352
Mailing Address - Country:US
Mailing Address - Phone:806-771-0995
Mailing Address - Fax:806-771-3813
Practice Address - Street 1:3223 S LOOP 289 STE 210
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1352
Practice Address - Country:US
Practice Address - Phone:806-771-0995
Practice Address - Fax:806-771-3813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCL8537Medicare Oscar/Certification