Provider Demographics
NPI:1467229955
Name:SPECIALTY INTEGRATIVE PALLIATIVE CARE LLC
Entity Type:Organization
Organization Name:SPECIALTY INTEGRATIVE PALLIATIVE CARE LLC
Other - Org Name:SPECIALTY IPC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KINNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-772-9129
Mailing Address - Street 1:8300 FM 1960 WEST
Mailing Address - Street 2:SUITE, 450, OFFICE 467
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070
Mailing Address - Country:US
Mailing Address - Phone:346-335-9360
Mailing Address - Fax:346-335-9362
Practice Address - Street 1:8300 FM 1960 WEST
Practice Address - Street 2:SUITE 450, OFFICE 467
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070
Practice Address - Country:US
Practice Address - Phone:346-335-9360
Practice Address - Fax:346-335-9362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity HealthGroup - Multi-Specialty
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty