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General NPI Number Information
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NPI Number | 1487460176
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Entity Type | Organization
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Legal Business Name | WEST TEXAS HOSPICE, LLC
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Dates
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Enumeration Date | 12/06/2024
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 5305 TRINITY BLVD STE A2
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City | SNYDER
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State | TX
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Zip | 79549-6166
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Country | US
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Telephone | 325-574-7340
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Fax | 325-573-1882
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Provider Business Mailing Address
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Address Line | 101 W RENNER RD STE 420
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City | RICHARDSON
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State | TX
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Zip | 75082-2022
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Country | US
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Telephone | 469-409-6256
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Fax | 469-409-6256
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | DONNIE MABERRY
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Credential |
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Telephone | 972-468-8070
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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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