Provider Demographics
NPI:1629275110
Name:TAJ HEALTHCARE, LLC
Entity Type:Organization
Organization Name:TAJ HEALTHCARE, LLC
Other - Org Name:OASIS HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHEATHAM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:512-310-3800
Mailing Address - Street 1:1001 S MAYS ST
Mailing Address - Street 2:SUITE 105-C
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-6725
Mailing Address - Country:US
Mailing Address - Phone:512-310-3800
Mailing Address - Fax:512-310-7854
Practice Address - Street 1:1001 S MAYS ST
Practice Address - Street 2:SUITE 105-C
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-6725
Practice Address - Country:US
Practice Address - Phone:512-310-3800
Practice Address - Fax:512-310-7854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXWAITING ON NUMBER251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0000Medicare ID - Type UnspecifiedAWAITING MEDICARE NUMBER