Provider Demographics
NPI:1992103980
Name:MESQUITE HOSPICE INC.
Entity type:Organization
Organization Name:MESQUITE HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KOMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-553-5675
Mailing Address - Street 1:3132 W MILLER RD STE C
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-6108
Mailing Address - Country:US
Mailing Address - Phone:214-473-4790
Mailing Address - Fax:972-288-2702
Practice Address - Street 1:3132 W MILLER RD STE C
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-6108
Practice Address - Country:US
Practice Address - Phone:214-473-4790
Practice Address - Fax:972-288-2702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-08
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
TX016746251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based