Provider Demographics
NPI:1306868377
Name:STAR HOME HEALTH INC
Entity type:Organization
Organization Name:STAR HOME HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CLEMENTINA
Authorized Official - Middle Name:O
Authorized Official - Last Name:IKWUEZUNMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-785-4949
Mailing Address - Street 1:6100 CORPORATE DR STE 330
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3419
Mailing Address - Country:US
Mailing Address - Phone:713-785-4949
Mailing Address - Fax:713-782-6100
Practice Address - Street 1:6100 CORPORATE DR STE 330
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3419
Practice Address - Country:US
Practice Address - Phone:713-478-0390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009600251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX009600OtherSTATE HOME HEALTH AGENCY
TX001014520OtherPHC/FC CONTRACT
TX45D1036286OtherCLIA WAIVER ID NUMBER
TX0092867OtherDURABLE MEDICAL EQUIPMENT
TXTXD 0013691OtherBEDDING LICENSE