Texas Hospice Providers LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

TEXAS HOSPICE PROVIDERS LLC

Practice address

2306 Guthrie Rd Ste 260H
Garland, TX 75043-5967

Phone

(972) 424-4401

Fax

(888) 343-2301

NPI assigned

Dec 14, 2020

Organization subpart

No

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

Authorized official

Name

Shijo K George

Title

Owner

Phone

(972) 424-4401

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Hospice certification: CCN 971768

Legal name

TEXAS HOSPICE PROVIDERS LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

May 5, 2022

Last certification

May 5, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Enrollment address

2306 Guthrie Rd
Ste 260H
Garland, TX 75043-5967

Listed as

Texas Hospice Providers LLCCCN 971768

Ownership

For-Profit

Certified

May 5, 2022

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 6

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 1

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

• Prince Philip, M.D.

  • Internal Medicine Physician
  • Mesquite, TX
  • NPI 1497108856

  W-2 Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mathew Vadakkeveettil Chacko, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
  • NPI 1104538552
  NPD

Affiliated clinicians 2

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

• Khoren Hekimian, DO

  • Family Medicine Physician
  • Troup, TX
  • NPI 1588695423

  Hospice

  Care Compare affiliation
• Prince Philip, M.D.

  • Internal Medicine Physician
  • Mesquite, TX
  • NPI 1497108856

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1568058675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 GUTHRIE RD STE 260H",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750435967",
            "telephone_number": "972-424-4401",
            "fax_number": "888-343-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 GUTHRIE RD STE 260H",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750435967",
            "telephone_number": "972-424-4401",
            "fax_number": "888-343-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS HOSPICE PROVIDERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-14",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "SHIJO",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-424-4401"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.