Provider Demographics
NPI:1437294527
Name:TRUE GUARDIAN HOSPICE, INC.
Entity Type:Organization
Organization Name:TRUE GUARDIAN HOSPICE, INC.
Other - Org Name:GUARDIAN HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BULLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-868-0267
Mailing Address - Street 1:2009 INDEPENDENCE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-0215
Mailing Address - Country:US
Mailing Address - Phone:903-868-0267
Mailing Address - Fax:903-868-0297
Practice Address - Street 1:2009 INDEPENDENCE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-0215
Practice Address - Country:US
Practice Address - Phone:903-868-0267
Practice Address - Fax:903-868-0297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001019549Medicaid