Provider Demographics
NPI:1356091631
Name:AVATAR PALLIATIVE CARE LLC
Entity Type:Organization
Organization Name:AVATAR PALLIATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARMATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJESH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-887-8223
Mailing Address - Street 1:100 N CENTRAL EXPY STE 190
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 N CENTRAL EXPY STE 190
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5302
Practice Address - Country:US
Practice Address - Phone:844-422-5528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty