MEDICARE: HARBOR HOSPICE MEDICAL CENTER - HOUSTON LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1225374218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARBOR HOSPICE MEDICAL CENTER - HOUSTON LP

Provider Business Mailing Address
First Line	:	3406 COLLEGE ST STE 200
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77701-4612
Country	:	US
Telephone Number	:	409-730-2022
Fax Number	:	409-232-0573

Provider Business Practice Location Address
First Line	:	11980 KIRBY DR STE 240
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77045-4860
Country	:	US
Telephone Number	:	713-777-5290
Fax Number	:	713-358-8927

Authorized Official
Title or Position	:	EXEC ADMIN ASST
Name	:	KAREN CARTER
Credential	:
Telephone Number	:	409-730-2046

Provider Enumeration Date	:	12/19/2012
Last Update Date	:	09/29/2021

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