Provider Demographics
NPI:1699817007
Name:HEALTHPRO HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:HEALTHPRO HOME HEALTH SERVICES
Other - Org Name:HEALTHPRO PRIMARY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:FOSTER
Authorized Official - Last Name:ROQUEMORE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:940-692-0599
Mailing Address - Street 1:3913 CALL FIELD RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-2640
Mailing Address - Country:US
Mailing Address - Phone:940-692-0599
Mailing Address - Fax:940-692-0580
Practice Address - Street 1:3913 CALL FIELD RD
Practice Address - Street 2:SUITE A
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-2640
Practice Address - Country:US
Practice Address - Phone:940-692-0599
Practice Address - Fax:940-692-0580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX006260251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health