MEDICARE: HEALTHCARE OF WEST TEXAS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist
2	251J00000X	Nursing Care Agency	010782	TX
3	225X00000X	Occupational Therapist	010782	TX
4	225100000X	Physical Therapist	010782	TX
5	251E00000X	Home Health Agency	010782	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	45D1021185	OTHER		CLIA
2	010782	OTHER	TX	STATE OPERATOR LICENSE

General Provider Information

NPI Number	:	1306021886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE OF WEST TEXAS LLC

Provider Business Mailing Address
First Line	:	101 W RENNER RD STE 420
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-2022
Country	:	US
Telephone Number	:	806-771-0995
Fax Number	:	806-771-3813

Provider Business Practice Location Address
First Line	:	2441 E US HIGHWAY 377 STE 105
Second Line	:
City	:	GRANBURY
State	:	TX
Zip	:	76049-6117
Country	:	US
Telephone Number	:	817-573-7474
Fax Number	:	817-279-0755

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	JOHN BRANDON DURBIN
Credential	:
Telephone Number	:	469-361-0120

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	02/11/2026

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Directions to “HEALTHCARE OF WEST TEXAS LLC ” Practice Location

Language	Start Address	Practice Location

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