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General NPI Number Information
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NPI Number | 1407122062
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Entity Type | Organization
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Legal Business Name | GOOD SHEPHERD HOSPICE OF HOUSTON LLC
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 110 CYPRESS STATION DR STE 200
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City | HOUSTON
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State | TX
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Zip | 77090-1629
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Country | US
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Telephone | 713-664-4447
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Fax | 713-664-4311
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Provider Business Mailing Address
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Address Line | 4350 WILL ROGERS PARKWAY SUITE 400
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City | OKLAHOMA CITY
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State | OK
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Zip | 73108-1840
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JASON DELESTER
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Credential |
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Telephone | 405-943-0903
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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 |
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License Number State |
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