Provider Demographics
NPI:1629412093
Name:PALLIATIVE CARE & INPATIENTS HOSPICE CORPORATION
Entity Type:Organization
Organization Name:PALLIATIVE CARE & INPATIENTS HOSPICE CORPORATION
Other - Org Name:PIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DON
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRECIOUS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-332-7235
Mailing Address - Street 1:10333 HARWIN DR
Mailing Address - Street 2:325
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-1545
Mailing Address - Country:US
Mailing Address - Phone:832-332-7235
Mailing Address - Fax:866-493-4007
Practice Address - Street 1:3204 W PARK AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-2024
Practice Address - Country:US
Practice Address - Phone:832-332-7235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPENDINGMedicaid
TXPENDINGMedicare Oscar/Certification