Deltacare Hospice, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

DELTACARE HOSPICE, LLC

Doing business as

Icon Hospice

Practice address

3132 W Miller Rd Ste B
Garland, TX 75041-6108

Phone

(214) 553-5675

Fax

(214) 553-5676

NPI assigned

Nov 24, 2009

Last updated

Aug 31, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Johnson George

Title

Administrator

Phone

(214) 473-4790

Specialties & licenses 1

Addresses

Other names 1

• Icon Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023346343. Details of each certification follow.

• CCN 671698 Hospice · Active · Details

Hospice certification: CCN 671698

Legal name

DELTACARE HOSPICE, LLC

Doing business as

ICON HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 20, 2011

Last certification

Apr 29, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Enrollment address

3132 W Miller Rd
# B
Garland, TX 75041-6108

Listed as

Icon HospiceCCN 671698 · All quality measures

Ownership

For-Profit

Certified

Oct 20, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Deitra Falgout Lebouef, APRN-BC

  • Family Nurse Practitioner
  • Plano, TX
  • NPI 1508153438

  W-2 Managing Employee

  CMS ownership
• Mihaela Perijoc, MD

  • Internal Medicine Physician
  • Plano, TX
  • NPI 1811933302

  5% Or Greater Direct Ownership Interest

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Ahmed Mohammed Alobaidi, M.D.

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1467778795

  Hospice

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1023346343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3132 W MILLER RD STE B",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750416108",
            "telephone_number": "214-473-4790",
            "fax_number": "469-405-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 W MILLER RD STE B",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750416108",
            "telephone_number": "214-553-5675",
            "fax_number": "214-553-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTACARE HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-24",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "JOHNSON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "214-473-4790"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Icon Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ruben Decoud, MA, LPC-A
• Bart Alan Deering, D.D.S.
• Lourdes Delgado, OTR/L
• Jacquelyn B Delin, MD
• Rachel Dell, PT, DPT
• Susan C Delzell, NP
• Reagan Nicole Demaree, M.S., CCC-SLP
• Samantha Demars, PT, DPT
• Kehua Deng
• Dennis M Abbott DDS PA (Dental Oncology Professionals)

• Community Based Hospice Care Agency in Garland, TX
• Providers in Garland, TX by specialty
• Community Based Hospice Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.