MEDICARE: PURE LIGHT HOSPICE AND PALLIATIVE CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1063389690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURE LIGHT HOSPICE AND PALLIATIVE CARE LLC

Provider Business Mailing Address
First Line	:	810 SUMMER VILLAGE WAY
Second Line	:
City	:	ROSENBERG
State	:	TX
Zip	:	77469-2857
Country	:	US
Telephone Number	:	832-762-1392
Fax Number	:

Provider Business Practice Location Address
First Line	:	810 SUMMER VILLAGE WAY
Second Line	:
City	:	ROSENBERG
State	:	TX
Zip	:	77469-2857
Country	:	US
Telephone Number	:	832-762-1392
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	EVANGEL OKAFOR
Credential	:	RN
Telephone Number	:	832-762-1392

Provider Enumeration Date	:	10/20/2025
Last Update Date	:	02/04/2026

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