MEDICARE: COMMUNITY HEALTHCARE OF TEXAS

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	005692	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	:	1710981527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTHCARE OF TEXAS

Provider Business Mailing Address
First Line	:	6100 WESTERN PLACE
Second Line	:	STE 500
City	:	FT WORTH
State	:	TX
Zip	:	76107-4600
Country	:	US
Telephone Number	:	817-870-2795
Fax Number	:	817-878-3717

Provider Business Practice Location Address
First Line	:	1341 W MOCKINGBIRD LANE
Second Line	:	STE 210E
City	:	DALLAS
State	:	TX
Zip	:	75247
Country	:	US
Telephone Number	:	214-920-8450
Fax Number	:	214-920-8496

Authorized Official
Title or Position	:	CEO
Name	:	VICTORIA JINGLE
Credential	:
Telephone Number	:	817-870-2795

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	01/03/2023

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Directions to “COMMUNITY HEALTHCARE OF TEXAS ” Practice Location

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