Provider Demographics
NPI:1295197929
Name:RED OAK PALLIATIVE AND HOSPICE CARE LLC
Entity Type:Organization
Organization Name:RED OAK PALLIATIVE AND HOSPICE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:SUJA
Authorized Official - Middle Name:
Authorized Official - Last Name:KURIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-584-7077
Mailing Address - Street 1:1708 TIGRIS TRL
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-1572
Mailing Address - Country:US
Mailing Address - Phone:214-288-5904
Mailing Address - Fax:
Practice Address - Street 1:1708 TIGRIS TRL
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-1572
Practice Address - Country:US
Practice Address - Phone:214-288-5904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based