Provider Demographics
NPI:1275999559
Name:HEART OF TEXAS HOSPICE-LONESTAR, LLC
Entity Type:Organization
Organization Name:HEART OF TEXAS HOSPICE-LONESTAR, LLC
Other - Org Name:HEART OF TEXAS HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BOOTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-383-1045
Mailing Address - Street 1:18568 FORTY SIX PKWY STE 2001
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6878
Mailing Address - Country:US
Mailing Address - Phone:830-730-7711
Mailing Address - Fax:210-568-6524
Practice Address - Street 1:12450 NETWORK BLVD STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3363
Practice Address - Country:US
Practice Address - Phone:830-730-7711
Practice Address - Fax:210-568-6524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-03
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7658251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based