MEDICARE: CONCIERGE PARK 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	118590	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	:	1487705273
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONCIERGE PARK LP

Provider Business Mailing Address
First Line	:	2310 ELDRIDGE PKWY S
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-5254
Country	:	US
Telephone Number	:	281-558-3900
Fax Number	:	281-558-4434

Provider Business Practice Location Address
First Line	:	2310 ELDRIDGE PKWY S
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-5254
Country	:	US
Telephone Number	:	281-558-3900
Fax Number	:	281-558-4434

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	CHRISTOPHER EHMAN
Credential	:
Telephone Number	:	281-558-3900

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	05/20/2021

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Directions to “CONCIERGE PARK LP ” Practice Location

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