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General NPI Number Information
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NPI Number | 1093894586
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Entity Type | Organization
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Legal Business Name | TRI STAR HOME CARE INC
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 12/26/2007
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Provider Practice Location Address
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Address Line | 1106 W 6TH ST
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City | CISCO
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State | TX
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Zip | 76437
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Country | US
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Telephone | 254-442-4996
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Fax | 254-442-2002
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Provider Business Mailing Address
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Address Line | 1106 W 6TH ST
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City | CISCO
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State | TX
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Zip | 76437
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Country | US
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Telephone | 254-442-4996
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Fax | 254-442-2002
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ROBIN WYLIE
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Credential |
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Telephone | 254-442-4996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 006403
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License Number State | TX
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