Provider Demographics
NPI:1114494416
Name:HOSPICE SERVICES INC
Entity Type:Organization
Organization Name:HOSPICE SERVICES INC
Other - Org Name:HOSPICE SERVICES INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUMANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KETHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-359-7936
Mailing Address - Street 1:2925 SKYWAY CIR N STE 100
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2925 SKYWAY CIR N
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-3510
Practice Address - Country:US
Practice Address - Phone:214-282-4367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-25
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based