MEDICARE: MERCIFUL HANDS 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	019046	OTHER	TX	STATE LICENSE

General Provider Information

NPI Number	:	1619456167
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCIFUL HANDS LLC

Provider Business Mailing Address
First Line	:	7207 REGENCY SQUARE BLVD # 260-26
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-3188
Country	:	US
Telephone Number	:	281-757-5555
Fax Number	:	832-413-0090

Provider Business Practice Location Address
First Line	:	7207 REGENCY SQUARE BLVD STE 260-26
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-3188
Country	:	US
Telephone Number	:	281-757-5555
Fax Number	:	832-413-0090

Authorized Official
Title or Position	:	PARTNER
Name	:	PRAKASH GOPALAKRISHNAN
Credential	:
Telephone Number	:	770-789-5667

Provider Enumeration Date	:	08/07/2018
Last Update Date	:	03/08/2021

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Directions to “MERCIFUL HANDS LLC ” Practice Location

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