MEDICARE: CENTRAL TEXAS HOMECARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	246Q00000X	Pathology Specialist/Technologist
4	251J00000X	Nursing Care Agency
5	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	45D2151156	OTHER		CLIA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	011575	OTHER	TX	STATE OPERATOR LICENSE #

General Provider Information

NPI Number	:	1013507557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL TEXAS HOMECARE, LLC

Provider Business Mailing Address
First Line	:	3223 S LOOP 289 STE 210
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79423-1352
Country	:	US
Telephone Number	:	806-771-0588
Fax Number	:	806-687-5966

Provider Business Practice Location Address
First Line	:	6428 S GENERAL BRUCE DR STE A
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-5809
Country	:	US
Telephone Number	:	254-771-4131
Fax Number	:	254-771-0752

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	SHELLY LYNN MARKER
Credential	:	RN
Telephone Number	:	806-771-0995

Provider Enumeration Date	:	01/19/2021
Last Update Date	:	09/11/2024

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Directions to “CENTRAL TEXAS HOMECARE, LLC ” Practice Location

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