Provider Demographics
NPI:1689214785
Name:BAYOU CITY HOSPICE LLC
Entity Type:Organization
Organization Name:BAYOU CITY HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SAMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-610-5461
Mailing Address - Street 1:292 S CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-6328
Mailing Address - Country:US
Mailing Address - Phone:832-610-5461
Mailing Address - Fax:
Practice Address - Street 1:292 S CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-6328
Practice Address - Country:US
Practice Address - Phone:832-610-5461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based