MEDICARE: STAT NURSING HOME HEALTH CARE, INC.

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	251C00000X	Developmentally Disabled Services Day Training Agency
2	251E00000X	Home Health Agency	010168	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	010168	OTHER	TX	TDADS LICENSE NUMBER

General Provider Information

NPI Number	:	1861436107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAT NURSING HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	2106 N MINNESOTA AVE
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78521-6921
Country	:	US
Telephone Number	:	956-554-7828
Fax Number	:	956-554-7829

Provider Business Practice Location Address
First Line	:	2106 N MINNESOTA AVE
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78521-6921
Country	:	US
Telephone Number	:	956-554-7828
Fax Number	:	956-554-7829

Authorized Official
Title or Position	:	CEO/ADMINISTRATOR
Name	:	DORA ZAVALA
Credential	:
Telephone Number	:	956-554-7828

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	06/01/2026

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