Provider Demographics
NPI:1144479346
Name:A TRINITY VALLEY HOSPICE PLLC
Entity type:Organization
Organization Name:A TRINITY VALLEY HOSPICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DEWEY
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:903-677-3500
Mailing Address - Street 1:300 S PRAIRIEVILLE ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-2544
Mailing Address - Country:US
Mailing Address - Phone:903-677-3500
Mailing Address - Fax:903-677-4700
Practice Address - Street 1:300 S PRAIRIEVILLE ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-2544
Practice Address - Country:US
Practice Address - Phone:903-677-3500
Practice Address - Fax:903-677-4700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based