MEDICARE: TEXAS PALLIATIVE SERVICES PA

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	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1942186556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS PALLIATIVE SERVICES PA

Provider Business Mailing Address
First Line	:	PO BOX 4060
Second Line	:	ATTN: REGULATORY
City	:	MOORESVILLE
State	:	NC
Zip	:	28117-4060
Country	:	US
Telephone Number	:	704-664-2876
Fax Number	:	704-230-0946

Provider Business Practice Location Address
First Line	:	12777 JONES RD STE 375-A
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-4647
Country	:	US
Telephone Number	:	832-478-1060
Fax Number	:	832-478-1061

Authorized Official
Title or Position	:	OWNER
Name	:	RONALD J. CROSSNO
Credential	:
Telephone Number	:	254-314-6849

Provider Enumeration Date	:	08/12/2025
Last Update Date	:	08/12/2025

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