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General NPI Number Information
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NPI Number | 1194852251
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Entity Type | Organization
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Legal Business Name | VICTORY HOSPICE OF TEXAS, LLC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 730 E PARK BLVD STE 208
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City | PLANO
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State | TX
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Zip | 75074-8850
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Country | US
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Telephone | 855-942-3687
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Fax | 855-710-7022
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Provider Business Mailing Address
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Address Line | PO BOX 325
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City | SHERMAN
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State | TX
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Zip | 75091-0325
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Country | US
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Telephone | 855-942-3687
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Fax | 855-710-7022
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Authorized Official
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Title or Position | MEMBER
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Name | JONATHAN AUSTIN
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Credential |
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Telephone | 580-380-5656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 011512
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License Number State | TX
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