Healthcare Provider Details

I. General information

NPI: 1699985739
Provider Name (Legal Business Name): HARBOR HOSPICE OF NEW BRAUNFELS, L.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 08/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1528 COMMON ST SUITE 1 AND 2
NEW BRAUNFELS TX
78130-3337
US

IV. Provider business mailing address

3406 COLLEGE ST STE 200
BEAUMONT TX
77701-4612
US

V. Phone/Fax

Practice location:
  • Phone: 830-214-0477
  • Fax: 830-584-0662
Mailing address:
  • Phone: 409-730-2022
  • Fax: 409-232-0573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRAD THIBODAUX
Title or Position: CHIEF DATA OFFICER
Credential:
Phone: 409-730-2022