Provider Demographics
NPI:1275043382
Name:KDB HOSPICE LLC
Entity Type:Organization
Organization Name:KDB HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-919-5797
Mailing Address - Street 1:1510 N HAMPTON RD STE 260
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-8310
Mailing Address - Country:US
Mailing Address - Phone:214-919-5797
Mailing Address - Fax:888-414-5160
Practice Address - Street 1:1510 N HAMPTON RD STE 260
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-8310
Practice Address - Country:US
Practice Address - Phone:214-919-5797
Practice Address - Fax:888-414-5160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-03
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based