MEDICARE: PINNACLE HEALTH FACILITIES OF TEXAS III LP

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	314000000X	Skilled Nursing Facility	114719	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396727210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE HEALTH FACILITIES OF TEXAS III LP

Provider Business Mailing Address
First Line	:	5420 W PLANO PKWY
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-4823
Country	:	US
Telephone Number	:	972-931-3800
Fax Number	:	972-767-6222

Provider Business Practice Location Address
First Line	:	8703 DAVIS BLVD
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76248-0309
Country	:	US
Telephone Number	:	817-577-9999
Fax Number	:	817-849-8388

Authorized Official
Title or Position	:	DIRECTOR OF REIMBURSEMENT
Name	:	MRS. JAMIE LATTURE COLLIER
Credential	:
Telephone Number	:	972-931-3800

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	04/06/2016

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