Provider Demographics
NPI:1336463165
Name:WEST TEXAS HOME HEALTH, INC.
Entity Type:Organization
Organization Name:WEST TEXAS HOME HEALTH, INC.
Other - Org Name:BLUEBONNET HOME HEALTH & HOSPICE COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-878-0202
Mailing Address - Street 1:120 W MACARTHUR ST
Mailing Address - Street 2:SUITE 121
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-2007
Mailing Address - Country:US
Mailing Address - Phone:405-878-0202
Mailing Address - Fax:405-273-6007
Practice Address - Street 1:1613 AMARILLO ST
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:TX
Practice Address - Zip Code:79095-4105
Practice Address - Country:US
Practice Address - Phone:806-447-2541
Practice Address - Fax:806-447-1264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012786251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
457550Medicare UPIN