MEDICARE: COSMOS HOSPICE OF AUSTIN, 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

General Provider Information

NPI Number	:	1508020181
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COSMOS HOSPICE OF AUSTIN, LLC

Provider Business Mailing Address
First Line	:	16435 DAWNCREST WAY
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77498-7164
Country	:	US
Telephone Number	:	281-703-9990
Fax Number	:	281-277-0774

Provider Business Practice Location Address
First Line	:	3409 EXECUTIVE CENTER DR
Second Line	:	SUITE 241
City	:	AUSTIN
State	:	TX
Zip	:	78731-1641
Country	:	US
Telephone Number	:	281-703-9990
Fax Number	:	281-277-0774

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SONAL R PATEL
Credential	:
Telephone Number	:	281-703-9990

Provider Enumeration Date	:	07/14/2008
Last Update Date	:	06/21/2018

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