Provider Demographics
NPI:1598729915
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:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:405-878-0202
Mailing Address - Street 1:304 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:FRIONA
Mailing Address - State:TX
Mailing Address - Zip Code:79035-2024
Mailing Address - Country:US
Mailing Address - Phone:806-247-0057
Mailing Address - Fax:806-247-0187
Practice Address - Street 1:304 E 11TH ST
Practice Address - Street 2:
Practice Address - City:FRIONA
Practice Address - State:TX
Practice Address - Zip Code:79035-2024
Practice Address - Country:US
Practice Address - Phone:806-247-0057
Practice Address - Fax:806-247-0187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010134251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677617Medicare ID - Type Unspecified