MEDICARE: ANGEL WINGS HEALTHCARE 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	251G00000X	Community Based Hospice Care Agency
2	251G00000X	Community Based Hospice Care Agency	251G00000X	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245601442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL WINGS HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	1201 N WATSON RD STE 187
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76006-6225
Country	:	US
Telephone Number	:	817-583-6636
Fax Number	:	817-538-9508

Provider Business Practice Location Address
First Line	:	1201 N WATSON RD STE 187
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76006-6225
Country	:	US
Telephone Number	:	817-583-6636
Fax Number	:	817-538-9508

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CHAKIRA FENTON
Credential	:	MHA
Telephone Number	:	817-583-6636

Provider Enumeration Date	:	10/13/2015
Last Update Date	:	03/27/2026

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Directions to “ANGEL WINGS HEALTHCARE LLC ” Practice Location

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