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NPI Code Detail

MEDICARE: FPACP CORPUS LLC

MEDICARE: FPACP CORPUS 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 Facility

General Provider Information

NPI Number : 1427519289
Entity Type Code : Organization
Provider Name (Legal Business Name) : FPACP CORPUS LLC
Provider Business Mailing Address
First Line : 2501 PARKVIEW DR STE 110
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-5841
Country : US
Telephone Number : 817-632-1000
Fax Number : 817-632-1001
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 : EXECUTIVE ASASISTANT
Name : MRS. JAIMIE PICKETT
Credential :
Telephone Number : 817-632-1000
Provider Enumeration Date : 03/26/2019
Last Update Date : 03/26/2019

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