MEDICARE: THE HERITAGE HOUSE OF PLANO, LLC

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	163WH1000X	Hospice Registered Nurse

General Provider Information

NPI Number	:	1245160720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HERITAGE HOUSE OF PLANO, LLC

Provider Business Mailing Address
First Line	:	1802 WEANNE DR
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-3106
Country	:	US
Telephone Number	:	214-632-2382
Fax Number	:	469-573-9352

Provider Business Practice Location Address
First Line	:	3453 HEARST CASTLE WAY
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-3605
Country	:	US
Telephone Number	:	214-632-2382
Fax Number	:	469-573-9352

Authorized Official
Title or Position	:	OWNER
Name	:	CYNTHIA MARIE BOGGS
Credential	:	MBA
Telephone Number	:	214-632-2382

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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