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NPI Code Detail

MEDICARE: PM MANAGEMENT-CORPUS CHRISTI NC III, LLC

MEDICARE: PM MANAGEMENT-CORPUS CHRISTI NC III, 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
1314000000XSkilled Nursing Facility127204TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25006OTHERTXFACILITY ID NO.

General Provider Information

NPI Number : 1306881495
Entity Type Code : Organization
Provider Name (Legal Business Name) : PM MANAGEMENT-CORPUS CHRISTI NC III, LLC
Provider Business Mailing Address
First Line : 600 N PEARL ST STE 1050
Second Line :
City : DALLAS
State : TX
Zip : 75201-7495
Country : US
Telephone Number : 214-252-7600
Fax Number : 214-252-7704
Provider Business Practice Location Address
First Line : 801 CANTWELL LN
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78408-2605
Country : US
Telephone Number : 361-882-4284
Fax Number : 361-882-6218
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MICHAEL BEAL
Credential :
Telephone Number : 214-252-7600
Provider Enumeration Date : 06/20/2006
Last Update Date : 03/04/2020

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