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General NPI Number Information
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NPI Number | 1639679541
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Entity Type | Organization
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Legal Business Name | PICC PALIATIVE CARE HOSPICE LLC
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 10/28/2022
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Provider Practice Location Address
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Address Line | 11111 RICHMOND AVE STE 130
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City | HOUSTON
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State | TX
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Zip | 77082-6665
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Country | US
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Telephone | 281-741-7701
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Fax | 281-741-7892
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Provider Business Mailing Address
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Address Line | 11111 RICHMOND AVE STE 130
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City | HOUSTON
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State | TX
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Zip | 77082-6665
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Country | US
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Telephone | 281-741-7701
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Fax | 281-741-7892
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Authorized Official
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Title or Position | COO
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Name | GEOFFREY LAPUZ JIMENEZ
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Credential |
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Telephone | 310-276-7388
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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 | TX
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