Provider Demographics
NPI:1942800529
Name:REMARKABLE LTC PARTNERS OF BRAZOS VALLEY, LP
Entity Type:Organization
Organization Name:REMARKABLE LTC PARTNERS OF BRAZOS VALLEY, LP
Other - Org Name:REMARKABLE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MABERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-468-8070
Mailing Address - Street 1:101 W RENNER RD, STE 420
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-2022
Mailing Address - Country:US
Mailing Address - Phone:806-587-0121
Mailing Address - Fax:806-587-0121
Practice Address - Street 1:1645 GREENS PRAIRIE RD W STE 401B-2
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8404
Practice Address - Country:US
Practice Address - Phone:979-314-2620
Practice Address - Fax:979-314-2920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-31
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
45D2280982OtherCLIA
TX020616OtherSTATE OPERATORS LICENSE