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NPI Code Detail

MEDICARE: LAKE WHITNEY HOME HEALTH SERVICES

MEDICARE: LAKE WHITNEY HOME HEALTH SERVICES
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
1251E00000XHome Health Agency009332TX

General Provider Information

NPI Number : 1629051180
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKE WHITNEY HOME HEALTH SERVICES
Provider Business Mailing Address
First Line : PO BOX 458
Second Line :
City : WHITNEY
State : TX
Zip : 76692-0458
Country : US
Telephone Number : 254-694-6626
Fax Number : 254-694-6391
Provider Business Practice Location Address
First Line : 200 N SAN JACINTO ST
Second Line :
City : WHITNEY
State : TX
Zip : 76692-2388
Country : US
Telephone Number : 254-694-6626
Fax Number : 254-694-6391
Authorized Official
Title or Position : ADMINISTRATOR
Name : DR. TARIQ MAHMOOD
Credential : M.D.
Telephone Number : 254-694-6626
Provider Enumeration Date : 11/29/2005
Last Update Date : 08/22/2020

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Directions to “LAKE WHITNEY HOME HEALTH SERVICES ” Practice Location

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