MEDICARE: NORTHEAST TEXAS HOME HEALTH AGENCY, LTD

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	251E00000X	Home Health Agency	007685	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	HH8314	OTHER	TX	BLUECROSS BLUE SHIELD

General Provider Information

NPI Number	:	1467591032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHEAST TEXAS HOME HEALTH AGENCY, LTD

Provider Business Mailing Address
First Line	:	8150 N CENTRAL EXPY STE 1800
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-1883
Country	:	US
Telephone Number	:	469-839-3777
Fax Number	:	469-983-2083

Provider Business Practice Location Address
First Line	:	210 SHANNON RD W
Second Line	:
City	:	SULPHUR SPRINGS
State	:	TX
Zip	:	75482-4652
Country	:	US
Telephone Number	:	903-885-5606
Fax Number	:	903-885-7566

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	CHRIS WALKER
Credential	:
Telephone Number	:	469-839-3706

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	03/27/2026

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