Healthcare Provider Details

I. General information

NPI: 1699776567
Provider Name (Legal Business Name): ODYSSEY HEALTHCARE OPERATING A LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 08/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 EAST 8TH STREET SUITE 410
ODESSA TX
79761-4733
US

IV. Provider business mailing address

717 N HARWOOD ST SUITE 1500
DALLAS TX
75201-6519
US

V. Phone/Fax

Practice location:
  • Phone: 432-552-1400
  • Fax: 432-333-3702
Mailing address:
  • Phone: 214-922-9711
  • Fax: 214-922-9752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number008309
License Number StateTX

VIII. Authorized Official

Name: MR. RODNEY DIRK ALLISON
Title or Position: SR VP AND CFO
Credential:
Phone: 214-922-9711