Provider Demographics
NPI: | 1053691816 |
---|---|
Name: | PILLANS HEALTHCARE |
Entity type: | Organization |
Organization Name: | PILLANS HEALTHCARE |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | MEMBER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | WILLIAM |
Authorized Official - Middle Name: | P |
Authorized Official - Last Name: | PILLANS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 214-244-4694 |
Mailing Address - Street 1: | 322 LINCOLN DR |
Mailing Address - Street 2: | |
Mailing Address - City: | STREETMAN |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75859-3287 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 903-389-5986 |
Mailing Address - Fax: | 903-389-6749 |
Practice Address - Street 1: | 716 MIMOSA DR |
Practice Address - Street 2: | |
Practice Address - City: | MINEOLA |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75773-2612 |
Practice Address - Country: | US |
Practice Address - Phone: | 903-569-5366 |
Practice Address - Fax: | 903-569-9050 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-08-25 |
Last Update Date: | 2011-08-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 314000000X | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 675981 | Medicare Oscar/Certification |