Provider Demographics
NPI:1356381677
Name:STANDARD REGIONAL HOME HEALTH INC
Entity type:Organization
Organization Name:STANDARD REGIONAL HOME HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:CRAWFORD
Authorized Official - Last Name:STANDARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-284-0047
Mailing Address - Street 1:111 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:TX
Mailing Address - Zip Code:76520-3310
Mailing Address - Country:US
Mailing Address - Phone:512-402-7820
Mailing Address - Fax:254-697-4064
Practice Address - Street 1:115 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:TX
Practice Address - Zip Code:76520-3330
Practice Address - Country:US
Practice Address - Phone:512-402-7820
Practice Address - Fax:512-402-7821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010520251E00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188977601Medicaid
TX457506Medicare Oscar/Certification