Provider Demographics
NPI:1902091960
Name:TRI-STAR HOMEHEALTH INC
Entity Type:Organization
Organization Name:TRI-STAR HOMEHEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DON
Authorized Official - Prefix:MR
Authorized Official - First Name:EZEKIEL
Authorized Official - Middle Name:TUNDE
Authorized Official - Last Name:ODENIRAN
Authorized Official - Suffix:
Authorized Official - Credentials:RNBSN
Authorized Official - Phone:281-888-7755
Mailing Address - Street 1:702 N RICHMOND RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:WHARTON
Mailing Address - State:TX
Mailing Address - Zip Code:77488-3008
Mailing Address - Country:US
Mailing Address - Phone:281-888-7755
Mailing Address - Fax:281-888-7755
Practice Address - Street 1:702 N RICHMOND RD
Practice Address - Street 2:SUITE F
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488-3008
Practice Address - Country:US
Practice Address - Phone:281-888-7755
Practice Address - Fax:281-888-7755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health