Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 251G00000X | Hospice Care, Community Based | | | | No |
| 2 | 251B00000X | Case Management | | | | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 000602400 | OTHER | TEXAS | DALLAS CLASS CM |
| 2 | 000613200 | OTHER | TEXAS | AB SA CLASS DS |
| 3 | 001017093 | OTHER | TEXAS | LUFKIN CLASS DS |
| 4 | 001017094 | OTHER | TEXAS | MIDLAND/ODESSA CLASS CM |
| 5 | 000613500 | OTHER | TEXAS | LUBBOCK CLASS DS |
| 6 | 001017087 | OTHER | TEXAS | CORPUS CHRISTI CLASS DS |
| 7 | 001017089 | OTHER | TEXAS | FORT WORTH CLASS CM |
| 8 | 001017084 | OTHER | TEXAS | AMARILLO CLASS CM |
| 9 | 000602300 | OTHER | TEXAS | ODESSA CLASS CM |
| 10 | 000613400 | OTHER | TEXAS | CORPUS CHRISTI CLASS DS |
| 11 | 001017095 | OTHER | TEXAS | SAN ANGELO CLASS DS |
| 12 | 000614300 | OTHER | TEXAS | LONGVIEW CLASS DS |
| 13 | 001017090 | OTHER | TEXAS | HOUSTON CLASS CM |
| 14 | 001017091 | OTHER | TEXAS | LONGVIEW CLASS DS |
| 15 | 001017092 | OTHER | TEXAS | LUBBOCK CLASS DS |
| 16 | 001017096 | OTHER | TEXAS | SAN ANTONIO CLASS CM |
| 17 | 001012152 | OTHER | TEXAS | HOUSTON CLAS CM |
| 18 | 001017083 | OTHER | TEXAS | ABILENE CLASS DS |
| 19 | 000602200 | OTHER | TEXAS | AMARILLO CLASS CM |
| 20 | 001015776 | OTHER | TEXAS | BEAUMONT CLASS DS |
| 21 | 001017085 | OTHER | TEXAS | AUSTIN CLASS CM |
| 22 | 001017088 | OTHER | TEXAS | DALLAS CLASS CM |
