Provider Demographics
NPI:1578906350
Name:GUIDING LIGHT HOSPICE, INC.
Entity Type:Organization
Organization Name:GUIDING LIGHT HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNUGANTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-254-5119
Mailing Address - Street 1:3218 NACOGDOCHES RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-3321
Mailing Address - Country:US
Mailing Address - Phone:210-585-2335
Mailing Address - Fax:210-787-1962
Practice Address - Street 1:3218 NACOGDOCHES RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-3321
Practice Address - Country:US
Practice Address - Phone:210-585-2335
Practice Address - Fax:210-787-1962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-11
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1027308Medicaid
TX741503Medicare PIN