Basic Information
| Provider Information | |||||||||
| NPI: | 1891244406 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OPTUM PALLIATIVE AND HOSPICE CARE OF TEXAS, INC. | ||||||||
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| OtherOrganizationName: | HOSPICE INSPIRIS OF TEXAS INC. | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1009 WINDCROSS CT. | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370672678 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152245443 | ||||||||
| FaxNumber: | 8447279218 | ||||||||
| Practice Location | |||||||||
| Address1: | 5859 FARINON DR | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782493460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106843900 | ||||||||
| FaxNumber: | 8447279218 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2016 | ||||||||
| LastUpdateDate: | 09/27/2016 | ||||||||
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| AuthorizedOfficialLastName: | ENDERLE | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | O. | ||||||||
| AuthorizedOfficialTitleorPosition: | SR. VICE PRESIDENT/CFO | ||||||||
| AuthorizedOfficialTelephone: | 8602210793 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PH0002X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | Hospice and Palliative Medicine | 207QH0002X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine | 207RH0002X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine |
No ID Information.