Provider Demographics
NPI:1073206504
Name:EMPYREAN HOSPICE OF TEXAS, LLC
Entity Type:Organization
Organization Name:EMPYREAN HOSPICE OF TEXAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP REGULATORY
Authorized Official - Prefix:
Authorized Official - First Name:PATIENCE
Authorized Official - Middle Name:GUSTI
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-935-5665
Mailing Address - Street 1:647 BRAWLEY SCHOOL RD STE 104
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6876
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8918 TESORO DR STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6219
Practice Address - Country:US
Practice Address - Phone:704-935-5665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based