MEDICARE: PILLAR HEALTHCARE, 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
1	207LA0401X	Addiction Medicine (Anesthesiology) Physician	G0654	TX

General Provider Information

NPI Number	:	1831339381
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PILLAR HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	11520 N CENTRAL EXPY STE 126
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-6652
Country	:	US
Telephone Number	:	214-417-5766
Fax Number	:	214-341-9997

Provider Business Practice Location Address
First Line	:	11520 N CENTRAL EXPY STE 126
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-6652
Country	:	US
Telephone Number	:	214-417-5766
Fax Number	:	214-341-9997

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	MR. BRIAN CRAIG
Credential	:	MA, THM, LPC
Telephone Number	:	214-417-5766

Provider Enumeration Date	:	02/24/2009
Last Update Date	:	02/24/2009

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Directions to “PILLAR HEALTHCARE, LLC ” Practice Location

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