Healthcare Provider Details

I. General information

NPI: 1235951260
Provider Name (Legal Business Name): PANHANDLE HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2024
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 ANDREWS HWY STE 100C
MIDLAND TX
79701-3873
US

IV. Provider business mailing address

101 W RENNER RD STE 420
RICHARDSON TX
75082-2022
US

V. Phone/Fax

Practice location:
  • Phone: 737-356-3798
  • Fax: 737-381-3453
Mailing address:
  • Phone: 877-525-3338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DONNIE MABERRY
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 877-945-2010