Provider Demographics
NPI:1629307293
Name:HEALTHBACK HOME HEALTH OF N.E. TEXAS, INC.
Entity Type:Organization
Organization Name:HEALTHBACK HOME HEALTH OF N.E. TEXAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:W
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-842-1700
Mailing Address - Street 1:16211 N MAY AVE
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-8871
Mailing Address - Country:US
Mailing Address - Phone:405-842-1700
Mailing Address - Fax:405-767-1695
Practice Address - Street 1:2501 SUMMERHILL RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-3568
Practice Address - Country:US
Practice Address - Phone:903-793-0282
Practice Address - Fax:903-793-2586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
677439Medicare PIN