Provider Demographics
NPI:1689331506
Name:BRAZORIA HOSPICE INC
Entity Type:Organization
Organization Name:BRAZORIA HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KINER
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:CALVIN
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:800-303-2614
Mailing Address - Street 1:3129 KINGSLEY DR STE 830
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8508
Mailing Address - Country:US
Mailing Address - Phone:800-303-2614
Mailing Address - Fax:800-303-2614
Practice Address - Street 1:3129 KINGSLEY DR STE 830
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8508
Practice Address - Country:US
Practice Address - Phone:800-303-2614
Practice Address - Fax:800-303-2614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-27
Last Update Date:2021-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based