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General NPI Number Information
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NPI Number | 1710981527
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTHCARE OF TEXAS
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 01/03/2023
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Provider Practice Location Address
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Address Line | 1341 W MOCKINGBIRD LANE STE 210E
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City | DALLAS
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State | TX
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Zip | 75247
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Country | US
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Telephone | 214-920-8450
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Fax | 214-920-8496
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Provider Business Mailing Address
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Address Line | 6100 WESTERN PLACE STE 500
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City | FT WORTH
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State | TX
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Zip | 76107-4600
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Country | US
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Telephone | 817-870-2795
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Fax | 817-878-3717
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Authorized Official
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Title or Position | CEO
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Name | VICTORIA JINGLE
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Credential |
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Telephone | 817-870-2795
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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 | 005692
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License Number State | TX
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