Healthcare Provider Details

I. General information

NPI: 1609018712
Provider Name (Legal Business Name): SRMC CENTER HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2009
Last Update Date: 04/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N SAN JACINTO ST
WHITNEY TX
76692-2388
US

IV. Provider business mailing address

200 N SAN JACINTO ST P.O. BOX 1629
WHITNEY TX
76692-2388
US

V. Phone/Fax

Practice location:
  • Phone: 254-694-4428
  • Fax: 254-694-0280
Mailing address:
  • Phone: 254-694-4428
  • Fax: 254-694-0280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. AMAN ALI SHAH
Title or Position: MANAGER
Credential: M.D,
Phone: 254-694-4428