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NPI Code Detail

MEDICARE: PB&K, LLC

MEDICARE: PB&K, 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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1386231306
Entity Type Code : Organization
Provider Name (Legal Business Name) : PB&K, LLC
Provider Business Mailing Address
First Line : 8101 BOAT CLUB RD STE 318
Second Line :
City : FORT WORTH
State : TX
Zip : 76179-3633
Country : US
Telephone Number : 682-708-3455
Fax Number :
Provider Business Practice Location Address
First Line : 8101 BOAT CLUB RD STE 318
Second Line :
City : FORT WORTH
State : TX
Zip : 76179-3633
Country : US
Telephone Number : 682-708-3455
Fax Number :
Authorized Official
Title or Position : OWNER
Name : PARKER REW
Credential :
Telephone Number : 682-708-3455
Provider Enumeration Date : 12/23/2020
Last Update Date : 12/23/2020

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Directions to “PB&K, LLC ” Practice Location

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