Provider Demographics
NPI:1174771554
Name:TEXAS PALLIATIVE CARE
Entity type:Organization
Organization Name:TEXAS PALLIATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:REAM
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MN
Authorized Official - Phone:903-266-3400
Mailing Address - Street 1:4111 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-6623
Mailing Address - Country:US
Mailing Address - Phone:903-266-3400
Mailing Address - Fax:903-566-0291
Practice Address - Street 1:4111 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-6623
Practice Address - Country:US
Practice Address - Phone:903-266-3400
Practice Address - Fax:903-566-0291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative MedicineGroup - Multi-Specialty