Provider Demographics
NPI:1669140729
Name:GLORIOUS PALLIATIVE CARE LLC
Entity type:Organization
Organization Name:GLORIOUS PALLIATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EGBUCHUNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-724-1168
Mailing Address - Street 1:11965 BISSONNET ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-1465
Mailing Address - Country:US
Mailing Address - Phone:713-724-1168
Mailing Address - Fax:713-541-6001
Practice Address - Street 1:11965 BISSONNET ST STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-1465
Practice Address - Country:US
Practice Address - Phone:713-724-1168
Practice Address - Fax:713-541-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based