MEDICARE: KONEKTZ LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center
2	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1235365966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KONEKTZ LLC

Provider Business Mailing Address
First Line	:	2902 S BUCKNER BLVD
Second Line	:	STE 300
City	:	DALLAS
State	:	TX
Zip	:	75227-6951
Country	:	US
Telephone Number	:	972-699-7700
Fax Number	:	214-452-9938

Provider Business Practice Location Address
First Line	:	2902 S BUCKNER BLVD
Second Line	:	STE 300
City	:	DALLAS
State	:	TX
Zip	:	75227-6951
Country	:	US
Telephone Number	:	972-699-7700
Fax Number	:	214-452-9938

Authorized Official
Title or Position	:	DIRECTOR OF ADMINISTRATION
Name	:	VICKY MICHAELS-KNARR
Credential	:
Telephone Number	:	972-699-7700

Provider Enumeration Date	:	06/09/2009
Last Update Date	:	09/17/2018

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Directions to “KONEKTZ LLC ” Practice Location

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