Healthcare Provider Details

I. General information

NPI: 1073103172
Provider Name (Legal Business Name): INTERIM HEALTHCARE OF WEST TEXAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2021
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 S GREGG ST STE C
BIG SPRING TX
79720-5462
US

IV. Provider business mailing address

3223 S LOOP 289 STE 210
LUBBOCK TX
79423-1352
US

V. Phone/Fax

Practice location:
  • Phone: 432-235-1164
  • Fax: 432-235-1169
Mailing address:
  • Phone: 806-771-0588
  • Fax: 806-687-5966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHELLY LYNN MARKER
Title or Position: PRESIDENT/CEO
Credential: RN
Phone: 806-771-0995