Provider Demographics
NPI:1518139237
Name:WEST TEXAS HEALTHCARE LLC
Entity Type:Organization
Organization Name:WEST TEXAS HEALTHCARE LLC
Other - Org Name:SAN ANGELO HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:WILLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-581-1223
Mailing Address - Street 1:PO BOX 130010
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75713-0010
Mailing Address - Country:US
Mailing Address - Phone:903-581-1223
Mailing Address - Fax:903-581-1253
Practice Address - Street 1:3134 EXECUTIVE DR STE B
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-6886
Practice Address - Country:US
Practice Address - Phone:325-655-6600
Practice Address - Fax:325-655-6602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747233Medicare Oscar/Certification