Healthcare Provider Details

I. General information

NPI: 1316374408
Provider Name (Legal Business Name): S&P GUPTA ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2013
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2604 E STATE HIGHWAY 71
BASTROP TX
78602-5094
US

IV. Provider business mailing address

2604 E STATE HIGHWAY 71
BASTROP TX
78602-5094
US

V. Phone/Fax

Practice location:
  • Phone: 512-581-8326
  • Fax:
Mailing address:
  • Phone: 512-985-6107
  • Fax: 512-379-7481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateTX

VIII. Authorized Official

Name: JUSTIN YARMARK
Title or Position: OWNER
Credential:
Phone: 512-987-4542