Provider Demographics
NPI:1386847580
Name:SOUTHERN TEXAS HOME HEALTH INC.
Entity Type:Organization
Organization Name:SOUTHERN TEXAS HOME HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WALLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:830-663-5240
Mailing Address - Street 1:181 COUNTY ROAD 677
Mailing Address - Street 2:
Mailing Address - City:DEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:78016-4420
Mailing Address - Country:US
Mailing Address - Phone:830-663-5240
Mailing Address - Fax:830-663-5243
Practice Address - Street 1:181 COUNTY ROAD 677
Practice Address - Street 2:
Practice Address - City:DEVINE
Practice Address - State:TX
Practice Address - Zip Code:78016-4420
Practice Address - Country:US
Practice Address - Phone:830-663-5240
Practice Address - Fax:830-663-5243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX743166Medicare Oscar/Certification