Healthcare Provider Details

I. General information

NPI: 1508116963
Provider Name (Legal Business Name): HARBOR HOSPICE OF SOUTHEAST HOUSTON, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11990 KIRBY DR
HOUSTON TX
77045-4860
US

IV. Provider business mailing address

3406 COLLEGE ST # 200 ATTN: LICENSING & CREDENTIALING
BEAUMONT TX
77701-4612
US

V. Phone/Fax

Practice location:
  • Phone: 713-413-5200
  • Fax: 713-583-8927
Mailing address:
  • Phone: 409-813-2332
  • Fax: 409-232-0573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number015201
License Number StateTX

VIII. Authorized Official

Name: KAREN CARTER
Title or Position: EXEC ADMIN ASSISTANT
Credential:
Phone: 409-730-2046